Locally advanced adenocarcinoma and adenosquamous carcinomas of the cervix compared to squamous cell carcinomas of the cervix in gynecologic oncology group trials of cisplatin-based chemoradiation.
OBJECTIVE
Conflicting results have been reported for adeno- and adenosquamous carcinomas of the cervix with respect to their response to therapy and prognosis. The current study sought to evaluate impact of adeno- and adenosquamous histology in the randomized trials of primary cisplatin-based chemoradiation for locally advanced cervical cancer.


METHODS
Patients with adeno- and adenosquamous cervical carcinomas were retrospectively studied and compared to squamous cell carcinomas in GOG trials of chemoradiation.


RESULTS
Among 1671 enrolled in clinical trials of chemoradiation, 182 adeno- and adenosquamous carcinomas were identified (10.9%). A higher percentage of adeno- and adenosquamous carcinomas were stage IB2 (27.5% versus 20.0%) and fewer had stage IIIB (21.4% versus 28.6%). The mean tumor size was larger for squamous than adeno- and adenosquamous. Adeno- and adenosquamous carcinomas were more often poorly differentiated (46.2% versus 26.8%). When treated with radiation therapy alone, the 70 patients with adeno- and adenosquamous carcinoma of the cervix showed a statistically poorer overall survival (p=0.0499) compared to the 647 patients with squamous cell carcinoma of the cervix. However, when treated with radiation therapy with concurrent cisplatin-based chemotherapy, the 112 patients with adeno- and adenosquamous carcinomas had a similar overall survival (p=0.459) compared the 842 patients with squamous cell carcinoma. Adverse effects to treatment were similar across histologies.


CONCLUSION
Adeno- and adenosquamous carcinomas of the cervix are associated with worse overall survival when treated with radiation alone but with similar progression-free and overall survival compared to squamous cell carcinomas of the cervix when treated with cisplatin based chemoradiation.
['Rose|Peter G|PG|', 'Java|James J|JJ|', 'Whitney|Charles W|CW|', 'Stehman|Frederick B|FB|', 'Lanciano|Rachelle|R|', 'Thomas|Gillian M|GM|']
D000230:Adenocarcinoma D000328:Adult D000971:Antineoplastic Combined Chemotherapy Protocols D018196:Carcinoma, Adenosquamous D002294:Carcinoma, Squamous Cell D059248:Chemoradiotherapy D002945:Cisplatin D004921:Erythropoietin D005260:Female D005472:Fluorouracil D006801:Humans D006918:Hydroxyurea D008875:Middle Aged D015999:Multivariate Analysis D009367:Neoplasm Staging D011379:Prognosis D016016:Proportional Hazards Models D011878:Radiotherapy D011994:Recombinant Proteins D012189:Retrospective Studies D016896:Treatment Outcome D047368:Tumor Burden D002583:Uterine Cervical Neoplasms
Adenocarcinoma Adenosquamous carcinoma Cervix Cisplatin-based chemoradiation GOG