title: Locally advanced adenocarcinoma and adenosquamous carcinomas of the cervix compared to squamous cell carcinomas of the cervix in gynecologic oncology group trials of cisplatin-based chemoradiation.
abstract: OBJECTIVE
  Conflicting results have been reported for adeno- and adenosquamous carcinomas of the cervix with respect to their response to therapy and prognosis. The current study sought to evaluate impact of adeno- and adenosquamous histology in the randomized trials of primary cisplatin-based chemoradiation for locally advanced cervical cancer.
  
  
  METHODS
  Patients with adeno- and adenosquamous cervical carcinomas were retrospectively studied and compared to squamous cell carcinomas in GOG trials of chemoradiation.
  
  
  RESULTS
  Among 1671 enrolled in clinical trials of chemoradiation, 182 adeno- and adenosquamous carcinomas were identified (10.9%). A higher percentage of adeno- and adenosquamous carcinomas were stage IB2 (27.5% versus 20.0%) and fewer had stage IIIB (21.4% versus 28.6%). The mean tumor size was larger for squamous than adeno- and adenosquamous. Adeno- and adenosquamous carcinomas were more often poorly differentiated (46.2% versus 26.8%). When treated with radiation therapy alone, the 70 patients with adeno- and adenosquamous carcinoma of the cervix showed a statistically poorer overall survival (p=0.0499) compared to the 647 patients with squamous cell carcinoma of the cervix. However, when treated with radiation therapy with concurrent cisplatin-based chemotherapy, the 112 patients with adeno- and adenosquamous carcinomas had a similar overall survival (p=0.459) compared the 842 patients with squamous cell carcinoma. Adverse effects to treatment were similar across histologies.
  
  
  CONCLUSIONS
  Adeno- and adenosquamous carcinomas of the cervix are associated with worse overall survival when treated with radiation alone but with similar progression-free and overall survival compared to squamous cell carcinomas of the cervix when treated with cisplatin based chemoradiation.
authors.affiliation: Gynecologic Oncology, Department of Obstetrics & Gynecology, Cleveland Clinic Foundation and Case Western Reserve University, Cleveland, OH 44195, United States. Electronic address: rosep@ccf.org.
authors.forename: Peter G
authors.initials: PG
authors.lastname: Rose
authors.affiliation: Gynecologic Oncology Group Statistical & Data Center, Roswell Park Cancer Institute, Buffalo, NY 14263, United States.
authors.forename: James J
authors.initials: JJ
authors.lastname: Java
authors.affiliation: Christiana Gynecologic Oncology, LLC, Apex Medical Center, Newark DE 19713, United States.
authors.forename: Charles W
authors.initials: CW
authors.lastname: Whitney
authors.affiliation: Gynecologic Oncology, Indiana University School of Medicine, Mel and Bren Simon Cancer Center, Indianapolis, IN 46202, United States.
authors.forename: Frederick B
authors.initials: FB
authors.lastname: Stehman
authors.affiliation: Radiation Oncology, Delaware County Regional Cancer Center, Drexel Hill, PA 19026, United States.
authors.forename: Rachelle
authors.initials: R
authors.lastname: Lanciano
authors.affiliation: Department of Radiation Oncology, Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON M4N 3 M5 Canada.
authors.forename: Gillian M
authors.initials: GM
authors.lastname: Thomas
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000628:therapy*; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D018196:Carcinoma, Adenosquamous / Q000473:pathology / Q000628:therapy*; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000628:therapy*; D059248:Chemoradiotherapy / Q000379:methods*; D002945:Cisplatin / Q000008:administration & dosage; D004921:Erythropoietin / Q000008:administration & dosage; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D006918:Hydroxyurea / Q000008:administration & dosage; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011379:Prognosis; D016016:Proportional Hazards Models; D011878:Radiotherapy / Q000379:methods; D011994:Recombinant Proteins / Q000008:administration & dosage; D012189:Retrospective Studies; D016896:Treatment Outcome; D047368:Tumor Burden; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000628:therapy*
chemical_list: D011994:Recombinant Proteins; D004921:Erythropoietin; D002945:Cisplatin; D005472:Fluorouracil; D006918:Hydroxyurea
keywords: Adenocarcinoma; Adenosquamous carcinoma; Cervix; Cisplatin-based chemoradiation; GOG