Erschienen in:
22.12.2015 | Original Article
Type C2 radical hysterectomy may improve outcomes of locally advanced mucinous adenocarcinoma of the uterine cervix
verfasst von:
Shinichi Okame, Atsumi Kojima, Norihiro Teramoto, Yuko Shiroyama, Takashi Yokoyama, Kazuhiro Takehara, Takayoshi Nogawa
Erschienen in:
International Journal of Clinical Oncology
|
Ausgabe 4/2016
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Abstract
Background
It is not known whether radiotherapy or surgery is better as initial treatment for locally advanced mucinous adenocarcinoma of the uterine cervix.
Methods
We reviewed the medical records and pathological materials of 32 patients with International Federation of Gynecology and Obstetrics stage IB2–IIB mucinous adenocarcinoma, who had undergone radiotherapy or radical hysterectomy as primary treatment between 2001 and 2010. p16INK4a immunohistochemistry was performed as a marker for human papillomavirus-related adenocarcinoma.
Results
Thirteen patients received radiotherapy and 19 patients underwent radical hysterectomy. The cumulative 3-year locoregional control rates in the radical hysterectomy and radiotherapy groups were 79.0 and 46.2 % (P = 0.03), and 5-year overall survival rates were 70.7 and 38.5 % (P = 0.09), respectively. Of patients with p16INK4a-positive tumors (n = 19), the cumulative 3-year locoregional control rates in the radical hysterectomy and radiotherapy groups were 100 and 60.0 % (P = 0.01), and 5-year overall survival rates were 88.9 and 40.0 % (P = 0.04), respectively. Conversely, the cumulative 3-year locoregional control rates in the human papillomavirus-negative radical hysterectomy group and radiotherapy group were 20.0 and 37.5 % (P = 0.66), and 5-year overall survival rates were 20.0 and 37.5 % (P = 0.60), respectively.
Conclusions
Radical hysterectomy may significantly improve locoregional control and overall survival compared with radiotherapy for stage IB2–IIB mucinous adenocarcinoma patients, especially those with p16INK4a-positive mucinous adenocarcinoma.