title: Impact of histological subtype on survival in patients with locally advanced cervical cancer that were treated with definitive radiotherapy: adenocarcinoma/adenosquamous carcinoma versus squamous cell carcinoma.
abstract: OBJECTIVE
  To compare the survival outcomes of patients with cervical squamous cell carcinoma (SCC) and adenocarcinoma/adenosquamous carcinoma (AC/ASC) among patients with locally advanced cervical cancer that were treated with definitive radiotherapy.
  
  
  METHODS
  The baseline characteristics and outcome data of patients with locally advanced cervical cancer who were treated with definitive radiotherapy between November 1993 and February 2014 were collected and retrospectively reviewed. A Cox proportional hazards regression model was used to investigate the prognostic significance of AC/ASC histology.
  
  
  RESULTS
  The patients with AC/ASC of the cervix exhibited significantly shorter overall survival (OS) (p=0.004) and progression-free survival (PFS) (p=0.002) than the patients with SCC of the cervix. Multivariate analysis showed that AC/ASC histology was an independent negative prognostic factor for PFS. Among the patients who displayed AC/ASC histology, larger tumor size, older age, and incomplete response to radiotherapy were found to be independent prognostic factors. PFS was inversely associated with the number of poor prognostic factors the patients exhibited (the estimated 1-year PFS rates; 100.0%, 77.8%, 42.8%, 0.0% for 0, 1, 2, 3 factors, respectively).
  
  
  CONCLUSIONS
  Locally advanced cervical cancer patients with AC/ASC histology experience significantly worse survival outcomes than those with SCC. Further clinical studies are warranted to develop a concurrent chemoradiotherapy (CCRT) protocol that is specifically tailored to locally advanced cervical AC/ASC.
authors.affiliation: Department of Obstetrics and Gynecology, Osaka University, Graduate School of Medicine, Osaka, Japan.
authors.forename: Eriko
authors.identifier: http://orcid.org/0000-0001-9514-1356
authors.initials: E
authors.lastname: Yokoi
authors.affiliation: Department of Obstetrics and Gynecology, Osaka University, Graduate School of Medicine, Osaka, Japan. smabuchi@gyne.med.osaka-u.ac.jp.
authors.forename: Seiji
authors.identifier: http://orcid.org/0000-0003-1803-1166
authors.initials: S
authors.lastname: Mabuchi
authors.affiliation: Department of Obstetrics and Gynecology, Osaka University, Graduate School of Medicine, Osaka, Japan.
authors.forename: Ryoko
authors.identifier: http://orcid.org/0000-0003-0397-4575
authors.initials: R
authors.lastname: Takahashi
authors.affiliation: Department of Obstetrics and Gynecology, Osaka University, Graduate School of Medicine, Osaka, Japan.
authors.forename: Yuri
authors.identifier: http://orcid.org/0000-0003-4300-5517
authors.initials: Y
authors.lastname: Matsumoto
authors.affiliation: Department of Obstetrics and Gynecology, Osaka University, Graduate School of Medicine, Osaka, Japan.
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Kuroda
authors.affiliation: Department of Obstetrics and Gynecology, Osaka University, Graduate School of Medicine, Osaka, Japan.
authors.forename: Katsumi
authors.identifier: http://orcid.org/0000-0002-9572-4989
authors.initials: K
authors.lastname: Kozasa
authors.affiliation: Department of Obstetrics and Gynecology, Osaka University, Graduate School of Medicine, Osaka, Japan.
authors.forename: Tadashi
authors.initials: T
authors.lastname: Kimura
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality* / Q000473:pathology / Q000532:radiotherapy; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D018196:Carcinoma, Adenosquamous / Q000401:mortality* / Q000473:pathology / Q000532:radiotherapy; D002294:Carcinoma, Squamous Cell / Q000401:mortality* / Q000473:pathology / Q000532:radiotherapy; D059248:Chemoradiotherapy; D002945:Cisplatin / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000401:mortality* / Q000473:pathology / Q000532:radiotherapy
chemical_list: D000970:Antineoplastic Agents; D002945:Cisplatin
keywords: Adenocarcinoma; Carcinoma, Adenosquamous; Radiotherapy; Uterine Cervical Neoplasms