Comparison of treatment outcomes between squamous cell carcinoma and adenocarcinoma in locally advanced cervical cancer

Abstract

Introduction: To compare the treatment outcomes between squamous cell carcinoma (SCC) and adenocarcinoma (ACA) in locally advanced cervical cancer patients. Methods: All medical records of stage IIB-IVA of cervical cancer patients who had been completed treatment between 1995 and 2008 were reviewed. ACA 1 case was matched for SCC 2 cases with clinical stage, tumor size, treatment modalities (radiation therapy (RT) vs concurrent chemoradiation (CCRT)). Treatment outcomes including response to RT/CCRT, time to complete response (CR), patterns of treatment failure and survival outcomes were recorded. Results: A total of 423 patients with stage IIB-IVA (141 ACA: 282 SCC) were included. More than half of all patients were in stage IIB. The overall complete responses (CR) between ACA and SCC were 86.5% and 94.7%, respectively (p=0.004). Median time to clinical CR from RT/CCRT of ACA were 2 months (0-5 months) compared with 1 month (0-4 months) for SCC (p=0.001). Pelvic recurrence and distant failure were found in 2.1% and 14.9% in ACA, and corresponding with 3.9% and 15.6% in SCC. The 5-year overall survival rates of ACA compared to SCC were 59.9% and 61.7% (p=0.191), respectively. When adjusted all prognostic factors, stage was only one factor which influenced to overall survival while tumor histology was not affecting factor. Conclusion: ACA in locally advanced cervical cancer used longer time to achieve CR and had poorer response rate from RT/CCRT than SCC. However, these effects did not influence to survival outcomes.