title: Prognostic significance of adenocarcinoma histology in women with cervical cancer.
abstract: OBJECTIVE
  We performed a population-based analysis to determine the effect of histology on survival for women with invasive cervical cancer.
  
  
  METHODS
  The Surveillance, Epidemiology and End Results database was used to identify women with stage IB-IVB cervical cancer treated from 1988 to 2005. Patients were stratified by histology (squamous, adenocarcinoma, and adenosquamous). Clinical characteristics, patterns of care, and outcomes were analyzed using multivariable logistic regression and Cox proportional hazards models.
  
  
  RESULTS
  A total of 24,562 patients were identified including 18,979 (77%) women with squamous cell carcinomas, 4103 (17%) with adencarcinomas, and 1480 (6%) with adenosquamous tumors. Women with adenocarcinomas were younger, more often white, and more frequently married than patients with squamous cell tumors (p<0.0001 for all). Patients with adenocarcinomas were more likely to present with early-stage disease (p<0.0001). At diagnosis, 26.7% of women with adenocarcinomas had stage IB1 tumors compared to 16.9% of those with squamous cell carcinomas. Among women with early-stage (IB1-IIA) tumors, patients with adenocarcinomas were 39% (HR=1.39; 95% CI, 1.23-1.56) more likely to die from their tumors than those with squamous cell carcinomas. For patients with advanced-stage disease (stage IIB-IVA) women with adenocarcinomas were 21% (HR=1.21; 95% CI, 1.10-1.32) more likely to die from their tumors than those with squamous neoplasms. Five-year survival for stage IIIB neoplasms five-year survival was 31.3% (95% CI, 29.2-33.3%) for squamous tumors vs. 20.3% (95% CI, 14.2-27.1%) for adenocarcinomas.
  
  
  CONCLUSIONS
  Cervical adenocarcinomas are more common in younger women and white patients. Adenocarcinoma histology negatively impacts survival for both early and advanced-stage carcinomas.
authors.affiliation: Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, 161 Fort Washington Ave, 8th Floor, New York, NY 10032, United States.
authors.forename: Vijaya
authors.initials: V
authors.lastname: Galic
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Herzog
authors.forename: Sharyn N
authors.initials: SN
authors.lastname: Lewin
authors.forename: Alfred I
authors.initials: AI
authors.lastname: Neugut
authors.forename: William M
authors.initials: WM
authors.lastname: Burke
authors.forename: Yu-Shiang
authors.initials: YS
authors.lastname: Lu
authors.forename: Dawn L
authors.initials: DL
authors.lastname: Hershman
authors.forename: Jason D
authors.initials: JD
authors.lastname: Wright
mesh_terms: D000230:Adenocarcinoma / Q000208:ethnology / Q000401:mortality* / Q000473:pathology*; D000328:Adult; D000367:Age Factors; D000368:Aged; D044383:Black People / Q000706:statistics & numerical data; D018196:Carcinoma, Adenosquamous / Q000208:ethnology / Q000401:mortality / Q000473:pathology; D002294:Carcinoma, Squamous Cell / Q000208:ethnology / Q000401:mortality / Q000473:pathology; D005260:Female; D006801:Humans; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011379:Prognosis; D018426:SEER Program; D014481:United States / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000208:ethnology / Q000401:mortality* / Q000473:pathology*; D044465:White People / Q000706:statistics & numerical data; D001741:Black or African American