title: Type C2 radical hysterectomy may improve outcomes of locally advanced mucinous adenocarcinoma of the uterine cervix.
abstract: BACKGROUND
  It is not known whether radiotherapy or surgery is better as initial treatment for locally advanced mucinous adenocarcinoma of the uterine cervix.
  
  
  METHODS
  We reviewed the medical records and pathological materials of 32 patients with International Federation of Gynecology and Obstetrics stage IB2-IIB mucinous adenocarcinoma, who had undergone radiotherapy or radical hysterectomy as primary treatment between 2001 and 2010. p16(INK4a) immunohistochemistry was performed as a marker for human papillomavirus-related adenocarcinoma.
  
  
  RESULTS
  Thirteen patients received radiotherapy and 19 patients underwent radical hysterectomy. The cumulative 3-year locoregional control rates in the radical hysterectomy and radiotherapy groups were 79.0 and 46.2 % (P = 0.03), and 5-year overall survival rates were 70.7 and 38.5 % (P = 0.09), respectively. Of patients with p16(INK4a)-positive tumors (n = 19), the cumulative 3-year locoregional control rates in the radical hysterectomy and radiotherapy groups were 100 and 60.0 % (P = 0.01), and 5-year overall survival rates were 88.9 and 40.0 % (P = 0.04), respectively. Conversely, the cumulative 3-year locoregional control rates in the human papillomavirus-negative radical hysterectomy group and radiotherapy group were 20.0 and 37.5 % (P = 0.66), and 5-year overall survival rates were 20.0 and 37.5 % (P = 0.60), respectively.
  
  
  CONCLUSIONS
  Radical hysterectomy may significantly improve locoregional control and overall survival compared with radiotherapy for stage IB2-IIB mucinous adenocarcinoma patients, especially those with p16(INK4a)-positive mucinous adenocarcinoma.
authors.affiliation: Department of Gynecologic Oncology, Shikoku Cancer Center, 160 Minamiumemoto, Matsuyama, Ehime, 791-0280, Japan. shookame@shikoku-cc.go.jp.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Okame
authors.affiliation: Department of Obstetrics and Gynecology, Iwate Medical University, 19-1 Uchimaru, Morioka, Iwate, 020-8505, Japan.
authors.forename: Atsumi
authors.initials: A
authors.lastname: Kojima
authors.affiliation: Department of Pathology, Shikoku Cancer, 160 Minamiumemoto, Matsuyama, Ehime, 791-0280, Japan.
authors.forename: Norihiro
authors.initials: N
authors.lastname: Teramoto
authors.affiliation: Department of Gynecologic Oncology, Shikoku Cancer Center, 160 Minamiumemoto, Matsuyama, Ehime, 791-0280, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Shiroyama
authors.affiliation: Department of Gynecologic Oncology, Shikoku Cancer Center, 160 Minamiumemoto, Matsuyama, Ehime, 791-0280, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Yokoyama
authors.affiliation: Department of Gynecologic Oncology, Shikoku Cancer Center, 160 Minamiumemoto, Matsuyama, Ehime, 791-0280, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Takehara
authors.affiliation: Department of Gynecologic Oncology, Shikoku Cancer Center, 160 Minamiumemoto, Matsuyama, Ehime, 791-0280, Japan.
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Nogawa
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000737:chemistry / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis; D019941:Cyclin-Dependent Kinase Inhibitor p16 / Q000032:analysis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D008499:Medical Records; D008875:Middle Aged; D009367:Neoplasm Staging; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000737:chemistry / Q000473:pathology / Q000601:surgery*
chemical_list: D014408:Biomarkers, Tumor; D019941:Cyclin-Dependent Kinase Inhibitor p16
keywords: Adenocarcinoma; Cervical cancer; Primary treatment; Prognosis; Radical hysterectomy; p16INK4a