title: The prognostic significance of histologic type in early stage cervical cancer - A multi-institutional study.
abstract: BACKGROUND
  Cervical adenocarcinomas (ADC) have been viewed as more aggressive than squamous cell carcinoma (SCC). We analyzed an international cohort of early stage cervical cancer to determine the impact of histologic type.
  
  
  METHODS
  Retrospective analysis of patients with SCC (148 patients) and ADC (130 patients) stages IA1-IB2 who underwent surgery at our three institutions (two from Detroit, one from Mexico) from 2000-2010 was performed for: age, stage, tumor size, lymphovascular invasion (LVI), invasion depth, lymph node status (LN), recurrence and survival. Pathologic review proceeded inclusion.
  
  
  RESULTS
  In the Latino population, ADC's tended to be higher grade (p=0.01), while SCC's were larger with deeper invasion (p<0.001). LVI and LN were not significantly different. Recurrence rate (RR) was 8% (8/101) in ADC and 11.8% (9/76) in SCCs. 5 year survival (OS) was equivalent (98.2% and 95.2% for ADC and SCC respectively, p=0.369). In the Detroit cohort, we noted no difference in size, grade, depth of invasion, LVI, LN. RR was 8/72 (13.7%) for SCC and 4/29 (13.7%) but not statistically different between the tumor types (p=0.5). 5 year survival was 91% and 92% for ADC and SCC, respectively. In this population 33% of the patients with SCC and 34% of the patients with ADC received adjuvant chemo-radiation (p=0.4). Histologic type demonstrated no significant outcome difference for any type of adjuvant therapy.
  
  
  CONCLUSIONS
  Comparing early stage disease cervical ADC and SCC suggests equivalent recurrence and survival. Therefore, the paradigm of more aggressive management of early stage cervical ADC warrants further investigation.
authors: Department of Oncology, Division of Gynecologic Oncology/Wayne State University/Karmanos Cancer Center, 4160 John R., Suite 721, Detroit, MI 48201, USA.
authors: Ira
authors: I
authors: Winer
authors: Department of Pathology, Hospital de Oncología, Centro Médico Nacional, IMSS, CMN Siglo XXI, Mexico City, DF 06720, Mexico.
authors: Isabel
authors: I
authors: Alvarado-Cabrero
authors: Department of Pathology/Wayne State University/Detroit Medical Center, Harper University Hospital, Prof. Bldg., 824-01 Department of Pathology, Detroit, MI 48201, USA.
authors: Oudai
authors: O
authors: Hassan
authors: Department of Pathology/Wayne State University/Detroit Medical Center, Harper University Hospital, Prof. Bldg., 824-01 Department of Pathology, Detroit, MI 48201, USA.
authors: Quratulain F
authors: QF
authors: Ahmed
authors: Department of Pathology/Wayne State University/Detroit Medical Center, Harper University Hospital, Prof. Bldg., 824-01 Department of Pathology, Detroit, MI 48201, USA.
authors: Baraa
authors: B
authors: Alosh
authors: Department of Pathology/Wayne State University/Detroit Medical Center, Harper University Hospital, Prof. Bldg., 824-01 Department of Pathology, Detroit, MI 48201, USA.
authors: Sudeshna
authors: S
authors: Bandyopadhyay
authors: Department of Pathology/Wayne State University/Detroit Medical Center, Harper University Hospital, Prof. Bldg., 824-01 Department of Pathology, Detroit, MI 48201, USA.
authors: Sumi
authors: S
authors: Thomas
authors: Department of OB/GYN/Wayne State University, Harper University Hospital, 4160 John R., Detroit, MI 48201, USA.
authors: Samet
authors: S
authors: Albayrak
authors: Department of OB/GYN/Henry Ford Hospital, 2799 West Grand Boulevard, Detroit, MI 48202, USA.
authors: Shobhana
authors: S
authors: Talukdar
authors: Department of Oncology, Division of Gynecologic Oncology/Wayne State University/Karmanos Cancer Center, 4160 John R., Suite 721, Detroit, MI 48201, USA.
authors: Zaid
authors: Z
authors: Al-Wahab
authors: Department of Radiation Oncology/Henry Ford Hospital, 2799 West Grand Boulevard, Detroit, MI 48202, USA.
authors: Mohamed A
authors: MA
authors: Elshaikh
authors: Department of OB/GYN, Division of Gynecologic Oncology/Henry Ford Hospital, 2799 West Grand Boulevard, Detroit, MI 48202, USA.
authors: Adnan
authors: A
authors: Munkarah
authors: Department of Oncology, Division of Gynecologic Oncology/Wayne State University/Karmanos Cancer Center, 4160 John R., Suite 721, Detroit, MI 48201, USA.
authors: Robert
authors: R
authors: Morris
authors: Department of Pathology/Wayne State University/Detroit Medical Center, Harper University Hospital, Prof. Bldg., 824-01 Department of Pathology, Detroit, MI 48201, USA. Electronic address: rali@med.wayne.edu.
authors: Rouba
authors: R
authors: Ali-Fehmi
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology*; D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000473:pathology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000473:pathology*
keywords: Adenocarcinoma (ADC); Squamous cell carcinoma (SCC)