Prognostic factors and clinicopathologic characteristics of invasive adenocarcinoma of the uterine cervix.
OBJECTIVE
The purpose of this study was to evaluate the outcome of patients with cervical adenocarcinoma and to determine the characteristics and the prognostic factors of this entity.


METHODS
This retrospective study was done in the Department of Surgical Oncology of the Salah Azaiz Institute of Tunis with 79 cases of invasive adenocarcinoma of the uterine cervix that were collected from 1990 to 1999. Survival was analyzed according to the Kaplan-Meier method. Univariate analysis of prognostic factors was performed with the test of log rank. Cox regression model was used in multivariate analysis of prognostic factors.


RESULTS
Mean age was 50 years, and metrorrhagia was mostly revealing in 73% of the cases. Early stages (I, IIa, IIb with 1/3 proximal parametrial invasion) and "pure" type adenocarcinoma were found in 78% and 87% of the cases, respectively. Treatment consisted of a radiosurgical combination in 52 cases; exclusive radiotherapy was practiced with 17 patients. The 5 year-overall and disease-free survival percentages were, respectively, 68% and 72.4%. Poor prognostic factors were age >50 years, tumor size >4 cm, advanced stage, tumor grade, and lymph nodes and lymph-vascular space involvement. With the use of multivariate analysis, only stage and lymph node metastases remained significant prognostic factors.


CONCLUSIONS
This report shows survival and prognostic factors that are similar to those found in previous studies, but unlike the Western countries, our results demonstrate a high rate of early stages and no increase in frequency of cervical adenocarcinoma.
Chargui
Riadh
R
Department of Surgical Oncology, Salah Azaiz Institute of Tunis, Tunis, Tunisia.
Damak
Tarak
T
Khomsi
Fethi
F
Ben Hassouna
Jamel
J
Chaieb
Walid
W
Hechiche
Monia
M
Gamoudi
Amor
A
Boussen
Hamouda
H
Benna
Farouk
F
Rahal
Khaled
K
D000230:Adenocarcinoma / Q000150:complications* / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007973:Leukorrhea / Q000209:etiology; D008207:Lymphatic Metastasis; D008796:Metrorrhagia / Q000209:etiology; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D002583:Uterine Cervical Neoplasms / Q000150:complications* / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery