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2017 | 15 | 1 | 68–77
Article title

Gruczołowy rak szyjki macicy leczony operacyjnie – czynniki prognostyczne i wyniki leczenia

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Cervical adenocarcinoma managed with surgery – prognostic factors and treatment outcomes 1
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Abstracts
EN
Aim of the study: Analysis of prognostic factors and treatment outcomes in patients with adenocarcinoma of the cervix treated by surgery. Material and methods: Data of 120 cervical adenocarcinoma patients treated in years 1985–2007 at the Department of Gynecologic Oncology of the Cancer Center, Division in Krakow were analyzed in detail. All patients were treated with primary surgery. The results of combination therapy were evaluated at the first follow-up appointment (6 weeks – 3 months) after completing adjuvant radiotherapy, based on a clinical examination and imaging tests. Progression-free survival and the 5-year survival rate were assumed as the criteria to evaluate the effectiveness of therapy. Survival probability was calculated with Kaplan–Meier estimate. Peto’s log-rank test was used to determine the statistic significance of the obtained differences, and the Cox hazard model was applied to assess the impact of given risk factors on patient mortality. Results: The 5-year survival rate in the group of 120 cervical adenocarcinoma patients was 74.3%. Thirty-two patients (26.6%) suffered a relapse. The average progression-free survival was 24.6 months, and median progression-free survival – 27 months. Multivariate analysis demonstrated a statistically significant detrimental effect of menopause, comorbidities, lymphovascular space invasion, and metastasis to pelvic lymph nodes on overall survival. Conclusions: Primary surgery is an effective method of treatment for patients with stage IA and IB cervical adenocarcinoma. Multivariate analysis showed a negative impact on overall survival of the following factors: menopause, comorbidities, lymphovascular space invasion, and metastasis to pelvic lymph nodes.
PL
Cel pracy: Analiza czynników prognostycznych oraz wyników leczenia chorych z gruczołowym rakiem szyjki macicy leczonych operacyjnie. Materiał i metody: Szczegółowej analizie poddano grupę 120 pacjentek z gruczołowym rakiem szyjki macicy leczonych w latach 1985–2007 w Klinice Ginekologii Onkologicznej Centrum Onkologii, Oddział w Krakowie. Wszystkie chore poddano pierwotnie leczeniu operacyjnemu. Wyniki leczenia skojarzonego oceniano podczas pierwszej kontroli (od 6 tygodni do 3 miesięcy) po zakończeniu uzupełniającej radioterapii na podstawie badania klinicznego i badań obrazowych. Jako kryterium oceny skuteczności leczenia przyjęto czas do progresji choroby oraz przeżycia 5-letnie. Prawdopodobieństwo przeżycia oszacowano metodą Kaplana–Meiera. W celu oceny istotności statystycznej prezentowanych w wynikach różnic posłużono się testem log-rank według Peto, a w celu oceny wpływu czynników na ryzyko zgonu – modelem hazardu Coxa. Wyniki: Odsetek przeżyć całkowitych 5-letnich w grupie 120 chorych z gruczołowym rakiem szyjki macicy wyniósł 74,3%. U 32 pacjentek (26,6%) wystąpił nawrót choroby nowotworowej. Średni czas do progresji wyniósł 24,6 miesiąca, a mediana czasu do progresji – 27 miesięcy. Analiza wielocechowa wykazała znamienny statystycznie negatywny wpływ menopauzy, chorób współistniejących, zajęcia naczyń limfatycznych i krwionośnych oraz przerzutów do węzłów chłonnych miednicznych na czas przeżycia całkowitego. Wnioski: Pierwotne leczenie chirurgiczne jest skuteczną metodą leczenia chorych z gruczołowym rakiem szyjki macicy w stopniach IA i IB. W analizie wieloczynnikowej niekorzystny wpływ na przeżycia mają: obecność menopauzy, choroby współistniejące, zatory z komórek raka w naczyniach limfatycznych oraz przerzuty w węzłach chłonnych miednicy mniejszej.
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Year
Volume
15
Issue
1
Pages
68–77
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References
  • 1. Wright TC, Ferenczy A, Kurman RJ: Carcinoma and other tumors of the cervix. In: Kurman RJ (ed.): Blaustein’s Pathology of the Female Genital Tract. 4th ed., Springer-Verlag, New York 1994: 279–326.
  • 2. Sherman ME, Wang SS, Carreon J et al.: Mortality trends for cervical squamous and adenocarcinoma in the United States. Relation to incidence and survival. Cancer 2005; 103: 1258–1264.
  • 3. Anton-Culver H, Bloss JD, Bringman D et al.: Comparison of adenocarcinoma and squamous cell carcinoma of the uterine cervix: a population-based epidemiologic study. Am J Obstet Gynecol 1992; 166: 1507–1514.
  • 4. Hopkins MP, Morley GW: A comparison of adenocarcinoma and squamous cell carcinoma of the cervix. Obstet Gynecol 1991; 77: 912–917.
  • 5. Platz CE, Benda JA: Female genital tract cancer. Cancer 1995; 75 (Suppl): 270–294.
  • 6. Smith HO, Tiffany MF, Qualls CR et al.: The rising incidence of adenocarcinoma relative to squamous cell carcinoma of the uterine cervix in the United States – a 24-year population-based study. Gynecol Oncol 2000; 78: 97–105.
  • 7. Iversen T, Abeler V, Kjørstad KE: Factors influencing the treatment of patients with stage IA carcinoma of the cervix. Br J Obstet Gynaecol 1979; 86: 593–597.
  • 8. Schorge JO, Lee KR, Flynn CE et al.: Stage IA1 cervical adenocarcinoma: definition and treatment. Obstet Gynecol 1999; 93: 219–222.
  • 9. Kaku T, Kamura T, Sakai K et al.: Early adenocarcinoma of the uterine cervix. Gynecol Oncol 1997; 65: 281–285.
  • 10. Hopkins MP, Peters WA 3rd, Andersen W et al.: Invasive cervical cancer treated initially by standard hysterectomy. Gynecol Oncol 1990; 36: 7–12.
  • 11. Kaspar HG, Dinh TV, Doherty MG et al.: Clinical implications of tumor volume measurement in stage I adenocarcinoma of the cervix. Obstet Gynecol 1993; 81: 296–300.
  • 12. Irie T, Kigawa J, Minagawa Y et al.: Prognosis and clinicopathological characteristics of Ib–IIb adenocarcinoma of the uterine cervix in patients who have had radical hysterectomy. Eur J Surg Oncol 2000; 26: 464–467.
  • 13. Baalbergen A, Veenstra Y, Stalpers L: Primary surgery versus primary radiotherapy with or without chemotherapy for early adenocarcinoma of the uterine cervix. Cochrane Database Syst Rev 2013; (1): CD006248.
  • 14. Huang YT, Wang CC, Tsai CS et al.: Clinical behaviors and outcomes for adenocarcinoma or adenosquamous carcinoma of cervix treated by radical hysterectomy and adjuvant radiotherapy or chemoradiotherapy. Int J Radiat Oncol Biol Phys 2012; 84: 420–427.
  • 15. Nakanishi T, Ishikawa H, Suzuki Y et al.: A comparison of prognoses of pathologic stage Ib adenocarcinoma and squamous cell carcinoma of the uterine cervix. Gynecol Oncol 2000; 79: 289–293.
  • 16. Katanyoo K, Sanguanrungsirikul S, Manusirivithaya S: Comparison of treatment outcomes between squamous cell carcinoma and adenocarcinoma in locally advanced cervical cancer. Gynecol Oncol 2012; 125: 292–296.
  • 17. Teke F, Yoney A, Teke M et al.: Lack of any impact of histopathology type on prognosis in patients with early-stage adenocarcinoma and squamous cell carcinoma of the uterine cervix. Asian Pac J Cancer Prev 2014; 15: 2815–2819.
  • 18. Park JY, Kim DY, Kim JH et al.: Outcomes after radical hysterectomy in patients with early-stage adenocarcinoma of uterine cervix. Br J Cancer 2010; 102: 1692–1698.
  • 19. Chen RJ, Chang DY, Yen ML et al.: Prognostic factors of primary adenocarcinoma of the uterine cervix. Gynecol Oncol 1998; 69: 157–164.
  • 20. Kato T, Watari H, Takeda M et al.: Multivariate prognostic analysis of adenocarcinoma of the uterine cervix treated with radical hysterectomy and systematic lymphadenectomy. J Gynecol Oncol 2013; 24: 222–228.
  • 21. Alfsen GC, Kristensen GB, Skovlund E et al.: Histologic subtype has minor importance for overall survival in patients with adenocarcinoma of the uterine cervix: a population-based study of prognostic factors in 505 patients with nonsquamous cell carcinomas of the cervix. Cancer 2001; 92: 2471–2483.
  • 22. Erzen M, Mozina A, Bertole J et al.: Factors predicting disease outcome in early stage adenocarcinoma of the uterine cervix. Eur J Obstet Gynecol Reprod Biol 2002; 101: 185–191.
  • 23. Kasamatsu T, Onda T, Sawada M et al.: Radical hysterectomy for FIGO stage I–IIB adenocarcinoma of the uterine cervix. Br J Cancer 2009; 100: 1400–1405.
  • 24. Baalbergen A, Ewing-Graham PC, Hop WC et al.: Prognostic factors in adenocarcinoma of the uterine cervix. Gynecol Oncol 2004; 92: 262–267.
  • 25. Zaal A, Zweemer RP, Zikán M et al.: Pelvic lymphadenectomy improves survival in patients with cervical cancer with low-volume disease in the sentinel node: a retrospective multicenter cohort study. Int J Gynecol Cancer 2014; 24: 303–311.
  • 26. Ditto A, Martinelli F, Lo Vullo S et al.: The role of lymphadenectomy in cervical cancer patients: the significance of the number and the status of lymph nodes removed in 526 cases treated in a single institution. Ann Surg Oncol 2013; 20: 3948–3954.
  • 27. Hosaka M, Watari H, Mitamura T et al.: Survival and prognosticators of node-positive cervical cancer patients treated with radical hysterectomy and systematic lymphadenectomy. Int J Clin Oncol 2011; 16: 33–38.
  • 28. Webb JC, Key CR, Qualls CR et al.: Population-based study of microinvasive adenocarcinoma of the uterine cervix. Obstet Gynecol 2001; 97: 701–706.
  • 29. McCann GA, Taege SK, Boutsicaris CE et al.: The impact of close surgical margins after radical hysterectomy for early-stage cervical cancer. Gynecol Oncol 2013; 128: 44–48.
  • 30. Sehouli J, Runnebaum IB, Fotopoulou C et al.: A randomized phase III adjuvant study in high-risk cervical cancer: simultaneous radiochemotherapy with cisplatin (S-RC) versus systemic paclitaxel and carboplatin followed by percutaneous radiation (PC-R): a NOGGO-AGO Intergroup Study. Ann Oncol 2012; 23: 2259–2264.
  • 31. Yamauchi M, Fukuda T, Wada T et al.: Comparison of outcomes between squamous cell carcinoma and adenocarcinoma in patients with surgically treated stage I–II cervical cancer. Mol Clin Oncol 2014; 2: 518–524.
  • 32. Hu T, Wu L, Xing H et al.: Development of criteria for ovarian preservation in cervical cancer patients treated with radical surgery with or without neoadjuvant chemotherapy: a multicenter retrospective study and meta-analysis. Ann Surg Oncol 2013; 20: 881–890.
  • 33. Singleton HM, Orr JW: Primary surgical treatment of invasive cancer. In: Singleton HM, Orr JW (eds.): Cancer of the Cervix. JB Lippincott Company, Philadelphia 1995: 174.
  • 34. Natsume N, Aoki Y, Kase H et al.: Ovarian metastasis in stage IB and II cervical adenocarcinoma. Gynecol Oncol 1999; 74: 255–258.
  • 35. Shimada M, Kigawa J, Nishimura R et al.: Ovarian metastasis in carcinoma of the uterine cervix. Gynecol Oncol 2006; 101: 234–237.
  • 36. Weinberg LE, Kunos CA, Zanotti KM: Lymphovascular space invasion (LVSI) is an isolated poor prognostic factor for recurrence and survival among women with intermediate- to highrisk early-stage endometrioid endometrial cancer. Int J Gynecol Cancer 2013; 23: 1438–1445.
  • 37. Dewdney SB, Jiao Z, Roma AA et al.: The prognostic significance of lymphovascular space invasion in laparoscopic versus abdominal hysterectomy for endometrioid endometrial cancer. Eur J Gynaecol Oncol 2014; 35: 7–10.
  • 38. Matsuo K, Yoshino K, Hiramatsu K et al.: Effect of lymphovascular space invasion on survival of stage I epithelial ovarian cancer. Obstet Gynecol 2014; 123: 957–965.
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article
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bwmeta1.element.psjd-bf7fb20f-f82d-4b61-aa8b-dc942a049609
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