Adenosquamous carcinoma versus adenocarcinoma in early-stage cervical cancer patients undergoing radical hysterectomy: An outcomes analysis

Objective.: To evaluate whether histology (adenocarcinoma versus adenosquamous carcinoma) is an independent prognostic indicator in patients with stage IB1 cervical cancer after radical hysterectomy. Methods.: All patients with adenocarcinoma or adenosquamous carcinoma who underwent radical hysterectomy between October 1990 and December 2006 at The University of Texas M. D. Anderson Cancer Center were evaluated. Clinico-pathological data collected included age, disease stage, tumor grade, lymph node status, parametrial involvement, depth of invasion, evidence of lymph-vascular space invasion (LVSI), and adjuvant therapy. Patients were categorized as having "low-risk" or "high-risk" disease depending on the final pathologic findings. Results.: We identified 126 patients with stage IB1 adenosquamous (n = 29) or adenocarcinoma (n = 97) cervical cancer. The median follow-up was 79 months (range 1.7-184.6). The median age was 40.3 years for patients with adenocarcinoma and 35.2 years for patients with adenosquamous carcinoma (P = 0.88). Grade III histology and LVSI were more common in patients with adenosquamous tumors than in patients with adenocarcinoma (85% versus 16%; P < 0.01 and 56.5% versus 32.8; P = 0.04). Histology was not associated with lymph node or parametrial involvement. There was no difference in recurrence rates between the two histologic groups, but the time to recurrence was shorter for patients with adenosquamous carcinoma (7.9 months versus 15 months; P = 0.01). There was no difference between cell types with regards to recurrence and recurrence-free survival rates in the low- and high-risk groups. Conclusion.: We found no evidence that histologic subtype affects outcome; however, the median time to recurrence was shorter in patients with adenosquamous carcinoma. Our study suggests that in patients with stage IB1 adenosquamous carcinoma or adenocarcinoma, the presence of high-risk features is more important than histologic subtype.