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01-05-2013 | Gynecologic Oncology

Does Histologic Type Correlate to Outcome after Pelvic Exenteration for Cervical and Vaginal Cancer?

Authors: Glauco Baiocchi, MD, PhD, Gustavo Cardoso Guimaraes, MD, PhD, Carlos Chaves Faloppa, MD, MSc, Lillian Yuri Kumagai, MD, MSc, Renato Almeida Rosa Oliveira, MD, Maria Dirlei Begnami, MD, PhD, Fernando Augusto Soares, MD, PhD, Ademar Lopes, MD, PhD

Published in: Annals of Surgical Oncology | Issue 5/2013

Abstract

Background

Adenocarcinoma (AC) of the cervix comprises 15–20 % of all cervical carcinomas, and data regarding the prognostic value of histologic type after pelvic exenteration (PE) are lacking. Our aim was to analyze the prognostic value of histologic type in overall survival (OS) and disease-specific survival (DSS) after PE and correlate it to clinical and pathologic variables.

Methods

We reviewed a series of 77 individuals who underwent PE for cervical or vaginal cancer from January 1980 to December 2010.

Results

Mean age was 54.5 years. Fifty-three patients (68.9 %) had cervical and 24 (31.1 %) vaginal cancer. Fifty-six (72.7 %) were squamous cell carcinoma (SCC) and 21 (27.3 %) ACs. We performed 42 (54.5 %) total, 18 anterior, 8 posterior, and 9 lateral extended PE. Median tumor size was 5 cm. Surgical margins were negative in 91.7 % of cases. Median operative time, length of hospital stay, and blood transfusion volume were, respectively, 420 (range 180–720) mins, 13.5 (range 4–79) days, and 900 (range 300–3900) ml. Median follow-up was 13.7 (range 1.09–114.3) months. SCC statistically correlated with presence of perineural invasion (p = 0.004). Five-year OS and DSS were, respectively, 24.4 and 37.1 %. SCC (p = 0.003) and grade 3 (p = 0.001) negatively affected OS in univariate analysis. SCC (p = 0.006), grade 3 (p = 0.003), perineural invasion (p = 0.03), lymph node metastasis (p = 0.02), and positive margins (p = 0.04) negatively affected DSS in univariate analysis. SCC and grade 3 retained the higher risk of death (OS and DSS) in multivariate analysis.

Conclusions

AC histology in cervical and vaginal cancer is associated with better outcome after PE compared to SCC.

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Title: Does Histologic Type Correlate to Outcome after Pelvic Exenteration for Cervical and Vaginal Cancer?
Authors: Glauco Baiocchi, MD, PhD
Gustavo Cardoso Guimaraes, MD, PhD
Carlos Chaves Faloppa, MD, MSc
Lillian Yuri Kumagai, MD, MSc
Renato Almeida Rosa Oliveira, MD
Maria Dirlei Begnami, MD, PhD
Fernando Augusto Soares, MD, PhD
Ademar Lopes, MD, PhD
Publication date: 01-05-2013
Publisher: Springer-Verlag
Published in: Annals of Surgical Oncology / Issue 5/2013
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-012-2768-6

At a glance: The STEP trials

Springer Medicine

Does Histologic Type Correlate to Outcome after Pelvic Exenteration for Cervical and Vaginal Cancer?

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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