title: Prognostic factors influencing decisions about surgical treatment of villoglandular adenocarcinoma of the uterine cervix.
abstract: OBJECTIVE
  The objectives of this study were to analyze the clinicopathologic features of villoglandular adenocarcinoma (VGA) of the uterine cervix, a variant of cervical adenocarcinoma with good prognosis, and to discuss the association of human papillomavirus (HPV) infection with VGA.
  
  
  METHODS
  A retrospective review of medical records was performed to identify the patients with VGA between 1999 and 2007 at the Samsung Medical Center.
  
  
  RESULTS
  Fifteen patients were identified among 171 women diagnosed with adenocarcinoma of the cervix. The median age was 40 years (range, 32-72 years). Four patients were treated by cone biopsy and 10 patients by hysterectomy with or without pelvic lymphadenectomy. Five patients had invasion of more than half of the depth of tumor in the cervix. Lymphovascular space invasion was present in 2 patients, one of whom also had lymph node metastases. Three recurrences were identified during the median follow-up of 64 months (range, 9-149 months). An HPV test was positive in 6 of 7 patients. Of the 6 patients with HPV infection, 2 were positive for HPV type 18, one for HPV type 6, and the remaining 3 were positive for 1 or more types of high-risk HPV.
  
  
  CONCLUSIONS
  Although VGA has been reported to have a favorable prognosis, we observed recurrences in those patients with close margins by the tumor, lymph node metastasis, or advanced stage. Human papillomavirus DNA, mostly HPV types 16 and 18, was associated with VGA. Further studies are warranted on prognostic factors and the pathogenetic role of HPV infections.
authors.affiliation: *Department of Obstetrics and Gynecology, Institute of Wonkwang Medical Science, College of Medicine, Wonkwang University, Iksan; Departments of †Obstetrics and Gynecology and ‡Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Ha-Jeong
authors.initials: HJ
authors.lastname: Kim
authors.forename: Ji-Hee
authors.initials: JH
authors.lastname: Sung
authors.forename: Eunjung
authors.initials: E
authors.lastname: Lee
authors.forename: Soomin
authors.initials: S
authors.lastname: Ahn
authors.forename: Sang Yong
authors.initials: SY
authors.lastname: Song
authors.forename: Chel Hun
authors.initials: CH
authors.lastname: Choi
authors.forename: Tae-Joong
authors.initials: TJ
authors.lastname: Kim
authors.forename: Byoung-Gie
authors.initials: BG
authors.lastname: Kim
authors.forename: Duk-Soo
authors.initials: DS
authors.lastname: Bae
authors.forename: Jeong-Won
authors.initials: JW
authors.lastname: Lee
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery*; D000328:Adult; D000368:Aged; D002755:Choice Behavior; D003657:Decision Making; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000706:statistics & numerical data*; D006801:Humans; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery; D011379:Prognosis; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery*