Impact of histological subtype on survival in patients with locally advanced cervical cancer that were treated with definitive radiotherapy: adenocarcinoma/adenosquamous carcinoma versus squamous cell carcinoma.
Impact of histological subtype on survival in patients with locally advanced cervical cancer that were treated with definitive radiotherapy: adenocarcinoma/adenosquamous carcinoma versus squamous cell carcinoma.
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DOI：
10.3802/jgo.2017.28.e19
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发表时间：
2017-03
影响因子：
3.9
通讯作者：
Kimura T
中科院分区：
文献类型：
--
作者：
Yokoi E;Mabuchi S;Takahashi R;Matsumoto Y;Kuroda H;Kozasa K;Kimura T
目的比较宫颈鳞状细胞癌(SCC)和腺癌/腺鳞癌(AC/ASC)患者在接受明确放疗的局部晚期宫颈癌患者中的生存结果。收集并回顾了1993年11月至2014年2月期间接受明确放射治疗的局部晚期宫颈癌患者的基线特征和预后数据。采用COX比例风险回归模型分析AC/ASC组织学分型对预后的影响。宫颈鳞癌患者的总生存期(OS)(p=0.004)和无进展生存期(PFS)(p=0.002)明显短于宫颈鳞癌患者。多因素分析显示AC/ASC组织学类型是PFS的独立负面预后因素。在显示AC/ASC组织学的患者中，肿瘤较大、年龄较大和对放射治疗反应不完全是独立的预后因素。PFS与患者表现出的不良预后因素的数量呈负相关(估计的1年PFS比率：100.0%、77.8%、42.8%、0.0%分别为0、1、2、3个因素)。具有AC/ASC组织学特征的局部晚期宫颈癌患者的生存结果显著低于那些具有SCC组织学特征的患者。有必要进行进一步的临床研究，以开发专门针对局部晚期宫颈AC/ASC的同步放化疗(CCRT)方案。
To compare the survival outcomes of patients with cervical squamous cell carcinoma (SCC) and adenocarcinoma/adenosquamous carcinoma (AC/ASC) among patients with locally advanced cervical cancer that were treated with definitive radiotherapy. The baseline characteristics and outcome data of patients with locally advanced cervical cancer who were treated with definitive radiotherapy between November 1993 and February 2014 were collected and retrospectively reviewed. A Cox proportional hazards regression model was used to investigate the prognostic significance of AC/ASC histology. The patients with AC/ASC of the cervix exhibited significantly shorter overall survival (OS) (p=0.004) and progression-free survival (PFS) (p=0.002) than the patients with SCC of the cervix. Multivariate analysis showed that AC/ASC histology was an independent negative prognostic factor for PFS. Among the patients who displayed AC/ASC histology, larger tumor size, older age, and incomplete response to radiotherapy were found to be independent prognostic factors. PFS was inversely associated with the number of poor prognostic factors the patients exhibited (the estimated 1-year PFS rates; 100.0%, 77.8%, 42.8%, 0.0% for 0, 1, 2, 3 factors, respectively). Locally advanced cervical cancer patients with AC/ASC histology experience significantly worse survival outcomes than those with SCC. Further clinical studies are warranted to develop a concurrent chemoradiotherapy (CCRT) protocol that is specifically tailored to locally advanced cervical AC/ASC.