title: Does histologic type correlate to outcome after pelvic exenteration for cervical and vaginal cancer?
abstract: BACKGROUND
  Adenocarcinoma (AC) of the cervix comprises 15-20 % of all cervical carcinomas, and data regarding the prognostic value of histologic type after pelvic exenteration (PE) are lacking. Our aim was to analyze the prognostic value of histologic type in overall survival (OS) and disease-specific survival (DSS) after PE and correlate it to clinical and pathologic variables.
  
  
  METHODS
  We reviewed a series of 77 individuals who underwent PE for cervical or vaginal cancer from January 1980 to December 2010.
  
  
  RESULTS
  Mean age was 54.5 years. Fifty-three patients (68.9 %) had cervical and 24 (31.1 %) vaginal cancer. Fifty-six (72.7 %) were squamous cell carcinoma (SCC) and 21 (27.3 %) ACs. We performed 42 (54.5 %) total, 18 anterior, 8 posterior, and 9 lateral extended PE. Median tumor size was 5 cm. Surgical margins were negative in 91.7 % of cases. Median operative time, length of hospital stay, and blood transfusion volume were, respectively, 420 (range 180-720) mins, 13.5 (range 4-79) days, and 900 (range 300-3900) ml. Median follow-up was 13.7 (range 1.09-114.3) months. SCC statistically correlated with presence of perineural invasion (p = 0.004). Five-year OS and DSS were, respectively, 24.4 and 37.1 %. SCC (p = 0.003) and grade 3 (p = 0.001) negatively affected OS in univariate analysis. SCC (p = 0.006), grade 3 (p = 0.003), perineural invasion (p = 0.03), lymph node metastasis (p = 0.02), and positive margins (p = 0.04) negatively affected DSS in univariate analysis. SCC and grade 3 retained the higher risk of death (OS and DSS) in multivariate analysis.
  
  
  CONCLUSIONS
  AC histology in cervical and vaginal cancer is associated with better outcome after PE compared to SCC.
authors.affiliation: Department of Gynecologic Oncology, AC Camargo Cancer Hospital, Sao Paulo, Brazil. glbaiocchi@yahoo.com.br
authors.forename: Glauco
authors.initials: G
authors.lastname: Baiocchi
authors.forename: Gustavo Cardoso
authors.initials: GC
authors.lastname: Guimaraes
authors.forename: Carlos Chaves
authors.initials: CC
authors.lastname: Faloppa
authors.forename: Lillian Yuri
authors.initials: LY
authors.lastname: Kumagai
authors.forename: Renato Almeida Rosa
authors.initials: RA
authors.lastname: Oliveira
authors.forename: Maria Dirlei
authors.initials: MD
authors.lastname: Begnami
authors.forename: Fernando Augusto
authors.initials: FA
authors.lastname: Soares
authors.forename: Ademar
authors.initials: A
authors.lastname: Lopes
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology* / Q000556:secondary / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001803:Blood Transfusion; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000556:secondary / Q000601:surgery; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay; D008207:Lymphatic Metastasis; D008875:Middle Aged; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness; D018365:Neoplasm, Residual; D061646:Operative Time; D010385:Pelvic Exenteration; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000601:surgery; D014625:Vaginal Neoplasms / Q000473:pathology* / Q000601:surgery