title: Risk factors for poor prognosis in microinvasive adenocarcinoma of the uterine cervix (IA1 and IA2): a pooled analysis.
abstract: OBJECTIVE
  To identify adverse risk factors for FIGO IA1 and IA2 cervical adenocarcinoma.
  
  
  METHODS
  PubMed was used to identify all microinvasive adenocarcinoma cases. Case specific data pooled for 35 "high risk" microinvasive adenocarcinoma (MIAC), defined as cases with lymph node or lymphovascular space involvement, positive surgical margins, or recurrence was compared with 478 "low risk" cases abstracted from the SEER database (1988-1997). Statistical methods included non-paired t and Fisher's Exact tests.
  
  
  RESULTS
  Survival for 1A1 and 1A2 MIAC is 99% and 98%, respectively. Significantly more 1A2 patients underwent aggressive radical surgery and received postoperative treatment. Parametrial involvement was rare (1/373 cases). Significantly more "high-risk" cases were of endometrioid histology (6/34 vs. 14/478, p=0.001), whereas adenocarcinoma (p=0.046) and mucinous (p=0.021) tumors were observed in the "low-risk" group. Among the "high-risk" cases with at least 5 years follow-up, 1.4% has recurred or died.
  
  
  CONCLUSIONS
  Endometrioid histology may be associated with late recurrence and worse survival in stage 1A1 and 1A2 MIAC.
authors.affiliation: Department of Obstetrics and Gynecology and Women's Health, Bronx, NY 10461, USA.
authors.forename: June
authors.initials: J
authors.lastname: Hou
authors.forename: Gary L
authors.initials: GL
authors.lastname: Goldberg
authors.forename: Clifford R
authors.initials: CR
authors.lastname: Qualls
authors.forename: Dennis Y S
authors.initials: DY
authors.lastname: Kuo
authors.forename: Aliza
authors.initials: A
authors.lastname: Forman
authors.forename: Harriet O
authors.initials: HO
authors.lastname: Smith
mesh_terms: D000230:Adenocarcinoma / Q000453:epidemiology / Q000473:pathology; D000328:Adult; D000367:Age Factors; D018269:Carcinoma, Endometrioid / Q000453:epidemiology / Q000473:pathology; D005260:Female; D006801:Humans; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D009367:Neoplasm Staging; D012307:Risk Factors; D018426:SEER Program; D014481:United States / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology / Q000473:pathology*