title: The effect of local treatment modalities in patients with early-stage adenocarcinoma of the uterine cervix: A population-based analysis.
abstract: BACKGROUND
  To determine the optimal local treatment modalities in stage IB-IIA adenocarcinoma (AC) of the uterine cervix and assess the impact of tumor size in the clinical outcomes.
  
  
  METHODS
  Patients with a primary diagnosis of stage IB-IIA cervical AC between 1988 and 2013 were identified using the Surveillance, Epidemiology, and End Results database. Cox regression analyses was performed to analyze the effect of local treatment modalities on cause-specific survival (CSS) and overall survival (OS).
  
  
  RESULTS
  A total of 2773 patients were identified. Of these, 1816, 795, and 162 patients received primary surgery, surgery and radiotherapy (RT), and primary RT, respectively. Local treatment modality was the independent prognostic factor for CSS and OS. Patients who received primary surgery had better CSS and OS, especially in patients with tumor size ≤4 cm. However, of those with tumor size >4 cm, patients who underwent primary surgery showed significantly better survival; the survival of patients who underwent surgery and RT was not significantly different from those who underwent primary RT alone. The results were not influenced by the year before (1988-1999) and after (2000-2013) the era of concurrent chemoradiation therapy.
  
  
  CONCLUSIONS
  Surgery remains the optimal local treatment modality in patients with early stage cervical AC.
authors.affiliation: Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xiamen University, Xiamen, 361003, People's Republic of China.
authors.forename: Juan
authors.initials: J
authors.lastname: Zhou
authors.affiliation: Department of Radiation Oncology, Xiamen Cancer Hospital, The First Affiliated Hospital of Xiamen University, Xiamen, 361003, People's Republic of China.
authors.forename: San-Gang
authors.initials: SG
authors.lastname: Wu
authors.affiliation: Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, 510060, People's Republic of China.
authors.forename: Jia-Yuan
authors.initials: JY
authors.lastname: Sun
authors.affiliation: Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, 510060, People's Republic of China.
authors.forename: Feng-Yan
authors.initials: FY
authors.lastname: Li
authors.affiliation: Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, 510060, People's Republic of China.
authors.forename: Huan-Xin
authors.initials: HX
authors.lastname: Lin
authors.affiliation: Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xiamen University, Xiamen, 361003, People's Republic of China. Electronic address: chendahongxmu@163.com.
authors.forename: Da-Hong
authors.initials: DH
authors.lastname: Chen
authors.affiliation: Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, 510060, People's Republic of China. Electronic address: hezhy@sysucc.org.cn.
authors.forename: Zhen-Yu
authors.initials: ZY
authors.lastname: He
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002681:China; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D009367:Neoplasm Staging; D012044:Regression Analysis; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D055815:Young Adult
keywords: Adenocarcinoma; Cervical cancer; Radiotherapy; Surgery