Objective: To determine
outcomes and prognostic factors for early-stage cervical
adenocarcinoma/ adenosquamous carcinomas (AC/ASC) patients who are treated with
radical hysterectomy and adjuvant therapy to optimize their treatment. Methods:
We retrospectively reviewed the medical records of 26 patients with
International Federation of Gynecologists and Obstetricians stage IB-IIB
cervical AC/ASC who were treated with radical hysterectomy and adjuvant
therapy. Overall survival (OS) and progression-free survival (PFS) were
calculated using the Kaplan-Meier method and compared using the log-rank test.
The prognostic significance of various clinical features was determined by
using multivariate analysis with the Cox proportional hazards regression model.
Results: Univariate analysis revealed that OS was significantly shorter in
patients with lymph node metastasis and lymphovascular space invasion.
Similarly, PFS was significantly shorter for patients with lymph node
metastasis and parametrial invasion. Furthermore, multivariate analysis showed
that lymph node metastasis was the only independent predictor for PFS (hazard
ratio: 6.47, 95% confidence interval: 1.33 - 31.44, p = 0.021). However, the
use of adjuvant chemoradiotherapy did not have any significant effect on either
OS or PFS, regardless of lymph node metastasis. Conclusions: Lymph node
metastasis is an independent prognostic factor for poor survival in cervical
AC/ASC patients treated with radical hysterectomy and adjuvant therapy. In
addition, adjuvant chemoradiotherapy does not improve their survival,
regardless of lymph node metastasis, which suggests that novel or personalized
adjuvant therapeutic strategies with fewer adverse effects than existing
strategies are needed.
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