Adenosquamous histology predicts a poor outcome for patients with advanced-stage, but not early-stage, cervical carcinoma

John H. Farley, Kimberly W. Hickey, Jay W. Carlson, G. Scott Rose, Edward R Kost, Terry A. Harrison

Research output: Contribution to journalArticle

88 Citations (Scopus)

Abstract

BACKGROUND. The objective of this study was to compare survival between patients with adenocarcinoma and patients with adenosquamous carcinoma of the cervix. METHODS. Patients who were diagnosed with invasive cervical carcinoma from 1988 to 1999 were identified from the Automated Central Tumor Registry for the United States Military Health Care System. Clinical data, including race, age at diagnosis, histology, tumor grade, disease stage, lymph node status, treatment modality, and survival, were collected. Survival analysis was performed with Kaplan-Meier survival curves and compared using the log-rank test. RESULTS. A total of 273 women were identified, 185 women with a histologic diagnosis of adenocarcinoma (AC) and 88 women with a diagnosis of adenosquamous carcinoma (ASC). Among the women with ASC, only 5% had Grade 1 tumors, and 66% had Grade 3 tumors. By comparison, among the women with AC, 37% had Grade 1 tumors, and 26% had Grade 3 tumors (P < 0.001). There was no difference in the incidence of positive lymph nodes or in the number of patients who underwent radical hysterectomy as primary treatment between patients with ASC and patients with AC. More patients with ASC received radiation therapy (51% vs. 28%) or chemotherapy (29% vs. 12%) as treatment (P < 0.001). Patients who had tumors with ASC histology had a significantly decreased 5-year survival rate compared with patients who had tumors with AC histology (65% vs. 83%; P < 0.002). When patients with early-stage cervical carcinoma (International Federation of Gynecology and Obstetrics [FIGO] Stage I) were examined separately, there was no statistically significant difference in the 5-year survival rate (AC, 89%; ASC, 86%; P = 0.644). However, when patients with advanced-stage disease (FIGO Stages II-IV) were analyzed, ASC was associated with a significant decrease in median and overall survival (P = 0.01). When the results were analyzed by grade, patients who had tumors with ASC histology had a shorter survival compared with patients who had AC histology of any grade; however, this was a significant difference only for patients with Grade 1 tumors: The 5-year survival rate for patients with Grade 1 AC was 93%, compared with 50% for patients with Grade 1 ASC (P < 0.01). CONCLUSIONS. ASC histology appears to be an independent predictor of poor outcome in women with cervical carcinoma compared with their counterparts who have pure AC. The significant decrease in survival was observed only in patients with advanced-stage cervical carcinoma. This decreased survival may be related mainly to the grade of ASC.

Original languageEnglish (US)
Pages (from-to)2196-2202
Number of pages7
JournalCancer
Volume97
Issue number9
DOIs
StatePublished - May 1 2003
Externally publishedYes

Fingerprint

Adenosquamous Carcinoma
Histology
Carcinoma
Adenocarcinoma
Neoplasms
Survival
Survival Rate
Gynecology
Obstetrics
Lymph Nodes
Kaplan-Meier Estimate
Survival Analysis
Hysterectomy
Cervix Uteri
Registries

Keywords

  • Adenosquamous
  • Carcinoma
  • Cervix
  • Survival

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Farley, J. H., Hickey, K. W., Carlson, J. W., Rose, G. S., Kost, E. R., & Harrison, T. A. (2003). Adenosquamous histology predicts a poor outcome for patients with advanced-stage, but not early-stage, cervical carcinoma. Cancer, 97(9), 2196-2202. https://doi.org/10.1002/cncr.11371

Adenosquamous histology predicts a poor outcome for patients with advanced-stage, but not early-stage, cervical carcinoma. / Farley, John H.; Hickey, Kimberly W.; Carlson, Jay W.; Rose, G. Scott; Kost, Edward R; Harrison, Terry A.

In: Cancer, Vol. 97, No. 9, 01.05.2003, p. 2196-2202.

Research output: Contribution to journalArticle

Farley, JH, Hickey, KW, Carlson, JW, Rose, GS, Kost, ER & Harrison, TA 2003, 'Adenosquamous histology predicts a poor outcome for patients with advanced-stage, but not early-stage, cervical carcinoma', Cancer, vol. 97, no. 9, pp. 2196-2202. https://doi.org/10.1002/cncr.11371
Farley, John H. ; Hickey, Kimberly W. ; Carlson, Jay W. ; Rose, G. Scott ; Kost, Edward R ; Harrison, Terry A. / Adenosquamous histology predicts a poor outcome for patients with advanced-stage, but not early-stage, cervical carcinoma. In: Cancer. 2003 ; Vol. 97, No. 9. pp. 2196-2202.
@article{9abf2c8181ed45ac80866556f293126f,
title = "Adenosquamous histology predicts a poor outcome for patients with advanced-stage, but not early-stage, cervical carcinoma",
abstract = "BACKGROUND. The objective of this study was to compare survival between patients with adenocarcinoma and patients with adenosquamous carcinoma of the cervix. METHODS. Patients who were diagnosed with invasive cervical carcinoma from 1988 to 1999 were identified from the Automated Central Tumor Registry for the United States Military Health Care System. Clinical data, including race, age at diagnosis, histology, tumor grade, disease stage, lymph node status, treatment modality, and survival, were collected. Survival analysis was performed with Kaplan-Meier survival curves and compared using the log-rank test. RESULTS. A total of 273 women were identified, 185 women with a histologic diagnosis of adenocarcinoma (AC) and 88 women with a diagnosis of adenosquamous carcinoma (ASC). Among the women with ASC, only 5{\%} had Grade 1 tumors, and 66{\%} had Grade 3 tumors. By comparison, among the women with AC, 37{\%} had Grade 1 tumors, and 26{\%} had Grade 3 tumors (P < 0.001). There was no difference in the incidence of positive lymph nodes or in the number of patients who underwent radical hysterectomy as primary treatment between patients with ASC and patients with AC. More patients with ASC received radiation therapy (51{\%} vs. 28{\%}) or chemotherapy (29{\%} vs. 12{\%}) as treatment (P < 0.001). Patients who had tumors with ASC histology had a significantly decreased 5-year survival rate compared with patients who had tumors with AC histology (65{\%} vs. 83{\%}; P < 0.002). When patients with early-stage cervical carcinoma (International Federation of Gynecology and Obstetrics [FIGO] Stage I) were examined separately, there was no statistically significant difference in the 5-year survival rate (AC, 89{\%}; ASC, 86{\%}; P = 0.644). However, when patients with advanced-stage disease (FIGO Stages II-IV) were analyzed, ASC was associated with a significant decrease in median and overall survival (P = 0.01). When the results were analyzed by grade, patients who had tumors with ASC histology had a shorter survival compared with patients who had AC histology of any grade; however, this was a significant difference only for patients with Grade 1 tumors: The 5-year survival rate for patients with Grade 1 AC was 93{\%}, compared with 50{\%} for patients with Grade 1 ASC (P < 0.01). CONCLUSIONS. ASC histology appears to be an independent predictor of poor outcome in women with cervical carcinoma compared with their counterparts who have pure AC. The significant decrease in survival was observed only in patients with advanced-stage cervical carcinoma. This decreased survival may be related mainly to the grade of ASC.",
keywords = "Adenosquamous, Carcinoma, Cervix, Survival",
author = "Farley, {John H.} and Hickey, {Kimberly W.} and Carlson, {Jay W.} and Rose, {G. Scott} and Kost, {Edward R} and Harrison, {Terry A.}",
year = "2003",
month = "5",
day = "1",
doi = "10.1002/cncr.11371",
language = "English (US)",
volume = "97",
pages = "2196--2202",
journal = "Cancer",
issn = "0008-543X",
publisher = "John Wiley and Sons Inc.",
number = "9",

}

TY - JOUR

T1 - Adenosquamous histology predicts a poor outcome for patients with advanced-stage, but not early-stage, cervical carcinoma

AU - Farley, John H.

AU - Hickey, Kimberly W.

AU - Carlson, Jay W.

AU - Rose, G. Scott

AU - Kost, Edward R

AU - Harrison, Terry A.

PY - 2003/5/1

Y1 - 2003/5/1

N2 - BACKGROUND. The objective of this study was to compare survival between patients with adenocarcinoma and patients with adenosquamous carcinoma of the cervix. METHODS. Patients who were diagnosed with invasive cervical carcinoma from 1988 to 1999 were identified from the Automated Central Tumor Registry for the United States Military Health Care System. Clinical data, including race, age at diagnosis, histology, tumor grade, disease stage, lymph node status, treatment modality, and survival, were collected. Survival analysis was performed with Kaplan-Meier survival curves and compared using the log-rank test. RESULTS. A total of 273 women were identified, 185 women with a histologic diagnosis of adenocarcinoma (AC) and 88 women with a diagnosis of adenosquamous carcinoma (ASC). Among the women with ASC, only 5% had Grade 1 tumors, and 66% had Grade 3 tumors. By comparison, among the women with AC, 37% had Grade 1 tumors, and 26% had Grade 3 tumors (P < 0.001). There was no difference in the incidence of positive lymph nodes or in the number of patients who underwent radical hysterectomy as primary treatment between patients with ASC and patients with AC. More patients with ASC received radiation therapy (51% vs. 28%) or chemotherapy (29% vs. 12%) as treatment (P < 0.001). Patients who had tumors with ASC histology had a significantly decreased 5-year survival rate compared with patients who had tumors with AC histology (65% vs. 83%; P < 0.002). When patients with early-stage cervical carcinoma (International Federation of Gynecology and Obstetrics [FIGO] Stage I) were examined separately, there was no statistically significant difference in the 5-year survival rate (AC, 89%; ASC, 86%; P = 0.644). However, when patients with advanced-stage disease (FIGO Stages II-IV) were analyzed, ASC was associated with a significant decrease in median and overall survival (P = 0.01). When the results were analyzed by grade, patients who had tumors with ASC histology had a shorter survival compared with patients who had AC histology of any grade; however, this was a significant difference only for patients with Grade 1 tumors: The 5-year survival rate for patients with Grade 1 AC was 93%, compared with 50% for patients with Grade 1 ASC (P < 0.01). CONCLUSIONS. ASC histology appears to be an independent predictor of poor outcome in women with cervical carcinoma compared with their counterparts who have pure AC. The significant decrease in survival was observed only in patients with advanced-stage cervical carcinoma. This decreased survival may be related mainly to the grade of ASC.

AB - BACKGROUND. The objective of this study was to compare survival between patients with adenocarcinoma and patients with adenosquamous carcinoma of the cervix. METHODS. Patients who were diagnosed with invasive cervical carcinoma from 1988 to 1999 were identified from the Automated Central Tumor Registry for the United States Military Health Care System. Clinical data, including race, age at diagnosis, histology, tumor grade, disease stage, lymph node status, treatment modality, and survival, were collected. Survival analysis was performed with Kaplan-Meier survival curves and compared using the log-rank test. RESULTS. A total of 273 women were identified, 185 women with a histologic diagnosis of adenocarcinoma (AC) and 88 women with a diagnosis of adenosquamous carcinoma (ASC). Among the women with ASC, only 5% had Grade 1 tumors, and 66% had Grade 3 tumors. By comparison, among the women with AC, 37% had Grade 1 tumors, and 26% had Grade 3 tumors (P < 0.001). There was no difference in the incidence of positive lymph nodes or in the number of patients who underwent radical hysterectomy as primary treatment between patients with ASC and patients with AC. More patients with ASC received radiation therapy (51% vs. 28%) or chemotherapy (29% vs. 12%) as treatment (P < 0.001). Patients who had tumors with ASC histology had a significantly decreased 5-year survival rate compared with patients who had tumors with AC histology (65% vs. 83%; P < 0.002). When patients with early-stage cervical carcinoma (International Federation of Gynecology and Obstetrics [FIGO] Stage I) were examined separately, there was no statistically significant difference in the 5-year survival rate (AC, 89%; ASC, 86%; P = 0.644). However, when patients with advanced-stage disease (FIGO Stages II-IV) were analyzed, ASC was associated with a significant decrease in median and overall survival (P = 0.01). When the results were analyzed by grade, patients who had tumors with ASC histology had a shorter survival compared with patients who had AC histology of any grade; however, this was a significant difference only for patients with Grade 1 tumors: The 5-year survival rate for patients with Grade 1 AC was 93%, compared with 50% for patients with Grade 1 ASC (P < 0.01). CONCLUSIONS. ASC histology appears to be an independent predictor of poor outcome in women with cervical carcinoma compared with their counterparts who have pure AC. The significant decrease in survival was observed only in patients with advanced-stage cervical carcinoma. This decreased survival may be related mainly to the grade of ASC.

KW - Adenosquamous

KW - Carcinoma

KW - Cervix

KW - Survival

UR - http://www.scopus.com/inward/record.url?scp=0037403437&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0037403437&partnerID=8YFLogxK

U2 - 10.1002/cncr.11371

DO - 10.1002/cncr.11371

M3 - Article

C2 - 12712471

AN - SCOPUS:0037403437

VL - 97

SP - 2196

EP - 2202

JO - Cancer

JF - Cancer

SN - 0008-543X

IS - 9

ER -