A Clinical Analysis Of 237 Cases Of Cervical Adenocarcinoma And Adenosquamous Carcinoma

Objective:In this study,we performed a comparison between cervical adenocarcinoma(AC)and adenosquamous carcinoma of cervix(ASC)patients admitted in Qilu hospital with respect to their clinical characters.And we further studied the relative factors on the prognosis of AC and ASC.Methods:We analyzed 237 cases who underwent radical surgery after a diagnosis of AC or ASC(FIGO stage IB1-IIA)in Qilu Hospital between June 2008 and September 2016.SPSS 20.0 statistical software was used for the comparison of the ages,clinical pathological figures,adjuvant therapies and prognosis of AC and ASC patients.Results:1.In our study,201(84.8%)with AC and 36(15.2%)with ASC,were analyzed.The ages of onset of AC and ASC were similar(44.23± 10.15 years old vs 45.19±6.21 years old;P=0.448),as well as the percentages of patients over 45 years old.2.A larger proportion of ASC patients had lymphovascular space invasion(LVSI),compared to AC patients(30.6%vs 12.4%,P=0.005).There were no significant differences in other clinical features between them,even though the tumor size of ASC was bigger and it was more common to find deep stromal invasion(DOI)in ASC.3.All these 237 patients underwent radical surgery.The adjuvant therapies,including radiotherapy(RT),chemotherapy,CCRT and RT plus chemotherapy,were applied according to the pathological results.Most of the patients received chemotherapy or CCRT after surgery,but there were no significant differences between AC and ASC on the models of adjuvant therapies.4.According to the univariate analysis,age(P=0.035,P=0.016),clinical stages(P<0.001,P<0.001),tumor size(P=0.012,P=0.008),LVSI(P=0.051,P=0.017),DOI(P=0.005,P=0.001),parametrium infiltration(P=0.001,P<0.001)and lymph node status(P<0.001,P<0.001)were all related to the overall survival(OS)and recurrence-free survival(RFS)of these patients,but histologic type had no significant impact on them.The multivariate analysis showed that lymph node metastasis was an independent prognostic factor for AC and ASC(P<0.001,P<0.001).5.For AC patients,72 cases of them received CCRT and for ASC patients,17 cases did.And no significant differences were noticed in 5-year OS(P=0.415)and RFS(P=0.522)between AC and ASC group for those who received CCRT,although the prognosis seemed better for AC patients.Conclusions:1.The ages of onset of AC and ASC were similar.Lymphovascular space invasion was more likely to occur in patients with ASC.2.Lymph node metastasis was an independent prognostic factor for AC and ASC.3.For all the included patients,histologic type had no significant impact on their OS and RFS.4.There was no obvious difference on prognosis between AC and ASC group for those who received CCRT in our hospital.