Cervical adenocarcinoma managed with surgery – prognostic factors and treatment outcomes
Affiliation and adress for correspondence
1 Department of Obstetrics and Gynecology, District Hospital in Chrzanów, Chrzanów, Poland
2 Department of Gynecologic Oncology, Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Division in Krakow, Krakow, Poland
Correspondence: Marek Jasiówka, MD, PhD, Department of Gynecologic Oncology, Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Division in Krakow, Garncarska 11, 31-115 Kraków, Poland, tel.: +48 668 641 133, e-mail: mj35@onet.eu
Curr Gynecol Oncol 2017, 15 (1), p. 68–77
DOI: 10.15557/CGO.2017.0006
ABSTRACT

Aim of the study: Analysis of prognostic factors and treatment outcomes in patients with adenocarcinoma of the cervix treated by surgery. Material and methods: Data of 120 cervical adenocarcinoma patients treated in years 1985–2007 at the Department of Gynecologic Oncology of the Cancer Center, Division in Krakow were analyzed in detail. All patients were treated with primary surgery. The results of combination therapy were evaluated at the first follow-up appointment (6 weeks – 3 months) after completing adjuvant radiotherapy, based on a clinical examination and imaging tests. Progression-free survival and the 5-year survival rate were assumed as the criteria to evaluate the effectiveness of therapy. Survival probability was calculated with Kaplan–Meier estimate. Peto’s log-rank test was used to determine the statistic significance of the obtained differences, and the Cox hazard model was applied to assess the impact of given risk factors on patient mortality. Results: The 5-year survival rate in the group of 120 cervical adenocarcinoma patients was 74.3%. Thirty-two patients (26.6%) suffered a relapse. The average progression-free survival was 24.6 months, and median progression-free survival – 27 months. Multivariate analysis demonstrated a statistically significant detrimental effect of menopause, comorbidities, lymphovascular space invasion, and metastasis to pelvic lymph nodes on overall survival. Conclusions: Primary surgery is an effective method of treatment for patients with stage IA and IB cervical adenocarcinoma. Multivariate analysis showed a negative impact on overall survival of the following factors: menopause, comorbidities, lymphovascular space invasion, and metastasis to pelvic lymph nodes.

Keywords: cervical cancer, radiotherapy, surgery