Comparison Of Adenocancer And Adenosquamous Cell Carcinoma In Stage I-IIA Cervical Cancer With Modified Radical Or Radical Hysterectomy

Öz

Aim: To compare the recurrence and survival time of adenocancer AC and adenosquamous ASC cell stage I-IIA cervical cancer patients with modified radical or radical hysterectomy.Materials and Methods: 44 AC and 20 ASC patients who underwent modified radical and radical hysterectomy in the gynecologic oncology clinic of the Tepecik Training and Research Hospital with early stage cervical cancer were enrolled in the study and the records of the follow-up patients were evaluated retrospectively. Patients with squamous cell, small cell and andifferentiated histological type cervical cancer, advanced stage stage IIB-IV patients, patients treated with radio chemo therapy in primary therapy and those without follow-up were excluded.Findings: It was found that there was no significant difference in recurrence rates between adenocancer and adenosquamous cell early stage cervical cancer patients treated with modified radical or radical hysterectomy. Five-year disease-free survival was calculated as 91.8% in AC patients and 100% in ASC patients P = 0.300 . The five-year median overall survival rates were 87.0% in AC patients and 85.3% in ASC patients P = 0.908 . There was no significant difference between the groups in five-year disease-free and total survival analysis.Conclusion: Among the rare histologic types of cervical cancer, adenocancer and adenosquamous cell carcinomas, treated with early stage modified radical and radical hysterectomy were not significantly different in terms of recurrence, disease-free survival and total survival.

Anahtar Kelimeler

• Adenocarcinoma,adenosquamous cell cervikal cancer,radical hysterectomy

Modifiye Radikal veya Radikal Histerektomi Yapılan Evre I-IIA Serviks Kanserinde Adeno kanser İle Adeno skuamoz Hücreli Kanserin Karşılaştırılması

Öz

Amaç: Evre I-IIA modifiye radikal veya radikal histerektomi uygulanan adeno kanser AC ile adeno skuamoz ASC hücreli serviks kanseri hastalarının nüks ve sağkalım sürelerinin karşılaştırılmasıdır.Gereç ve Yöntemler: Erken evre serviks kanseri tanısı ile ve Tepecik Eğitim Araştırma hastanesi jinekoloji onkoloji kliniğinde modifiye radikal ve radikal histerektomi işlemi uygulanan 44 AC ve 20 ASC hastası çalışmaya dahil edildi ve takip edilen hastaların kayıtları retrospektif olarak değerlendirildi. Çalışmaya kabul edilmeme kriterleri; skuamoz hücreli, küçük hücreli ve andiferansiye histolojik tipli serviks kanseri, ileri evre evre IIB-IV hastalar, primer tedavide radyo kemo terapi ile tedavi edilen ve takiplere gelmeyen hastalar olarak belirlendi.Bulgular: Adeno kanser ve adeno skuamoz hücreli erken evre modifiye radikal veya radikal histerektomi uygulanan serviks kanseri hastalarında nüks gelişme oranlarında anlamlı farklılık olmadığı bulundu. Beş yıllık hastalıksız sağkalım süresi AC hastalarında ortalama 91,8% ve ASC hastalarında ortalama 100% olarak hesaplandı P=0,300 . Beş yıllık ortalama toplam sağkalım oranları AC hastalarında %87,0 ve ASC hastalarında %85,3 olarak bulundu P=0,908 . Beş yıllık hastalıksız ve toplam sağkalım süreleri ile yapılan analizde gruplar arasında anlamlı farklılık olmadığı görüldü.Sonuç: Erken evre modifiye radikal ve radikal histerektomi uygulanan serviks kanserinde nadir görülen histolojik tiplerden adeno kanser ve adeno skuamoz hücreli kanserler arasında nüks, hastalıksız sağkalım ve total sağkalım süreleri açısından anlamlı farklılık olmadığı saptandı.

Anahtar Kelimeler

• Adeno kanser,adeno skuamoz hücreli serviks kanseri,radikal histerektomi

Kaynakça

1. Seiji Mabuchi, Mika Okazawa, Yasuto Kinose, Koji Matsuo, Masateru Fujiwara, Osamu Suzuki, Eiichi Morii, Shoji Kamiura, Kazuhiko Ogawa, and Tadashi Kimura. Comparison of the Prognoses of FIGO Stage I to Stage II Adenosquamous Carcinoma and Adenocarcinoma of the Uterine Cervix Treated With Radical Hysterectomy. Int J Gynecol Cancer 2012;22: 1389&1397.
2. Person OK, Yosefia S and Abdah-Bortnyak R. Response of adenocar- cinoma of the uterine cervix to chemoradiotherapy. Oncology Letters 9: 2791-2794, 2015.
3. Macdonald OK, Chen J, Dodson M, et al. Prognostic significance of histo- logy and positive lymph node involvement following radical hysterectomy in carcinoma of the cervix. Am J Clin Oncol. 2009;32:411Y416.
4. Lee JY, Kim YT, Kim S, Lee B, Lim MC, Kim JW, Won YJ. Prognosis of Cervical Cancer in the Era of Concurrent Chemoradiation from National Database in Korea: A Comparison between Squamous Cell Carcinoma and Adenocarcinoma. Plos One 2015. Dec 14;10(12):e0144887
5. Seiji Mabuchi, Mika Okazawa, Yasuto Kinose, Koji Matsuo, Masateru Fu- jiwara, Osamu Suzuki, Eiichi Morii, Shoji Kamiura, Kazuhiko Ogawa, and Tadashi Kimura. Comparison of the Prognoses of FIGO Stage I to Stage II Adenosquamous Carcinoma and Adenocarcinoma of the Uterine Cer- vix Treated With Radical Hysterectomy. Int J Gynecol Cancer 2012;22: 1389Y1397
6. Baek MH, Park JY, Kim D, Suh DS, Kim JH, Kim YM, Kim YT, Nam JH. Comparison of adenocarcinoma and adenosquamous carcinoma in pa- tients with early-stage cervical cancer after radical surgery. Gynecol On- col. 2014 Dec;135(3):462-7.
7. Chen JL, Cheng JC, Kuo SH, Chen CA, Lin MC, Huang CY. Outcome analysis of cervical adenosquamous carcinoma compared with adeno- carcinoma. Acta Obstet Gynecol Scand. 2012 Oct;91(10):1158-66.
8. Meng YH, Li S, Hu T, Ma D, Lu YP, Wang H. Clinical analysis of 132 cases of cervical adenosquamous carcinoma and cervical adenocarcinoma. Chin J Cancer. 2010 Jan;29(1):15-9.

9. Noh JM, Park W, Kim YS, Kim JY, Kim HJ, Kim J, Kim JH, Yoon MS, Choi JH, Yoon WS, Kim JY, Huh SJ .Comparison of clinical outcomes of adenocarcinoma and adenosquamous carcinoma in uterine cervical cancerpatients receiving surgical resection followed by radiotherapy: a multicenter retrospective study (KROG 13-10). Gynecol Oncol. 2014 Mar;132(3):618-23
10. dos Reis R, Frumovitz M, Milam M.R., Capp E, Sun C.C., Coleman RL, Ramirez PT. Adenosquamous carcinoma versus adenocarcinoma in ear- ly-stage cervical cancer patients undergoing radical hysterectomy: An outcomes analysis. Gynecology oncology 2007 december 107;458-463.
11. Lee JY, Lee C, Hahn SK, Kim HS, Chung HH, Kim JW, Park NH, Song YS. A Comparison of Adenosquamous Carcinoma and Adenocarcino- ma of the Cervix after Radical Hysterectomy. Gynecol Obstet Invest. 2015;80(1):15-20