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Type C2 radical hysterectomy may improve outcomes of locally advanced mucinous adenocarcinoma of the uterine cervix

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Abstract

Background

It is not known whether radiotherapy or surgery is better as initial treatment for locally advanced mucinous adenocarcinoma of the uterine cervix.

Methods

We reviewed the medical records and pathological materials of 32 patients with International Federation of Gynecology and Obstetrics stage IB2–IIB mucinous adenocarcinoma, who had undergone radiotherapy or radical hysterectomy as primary treatment between 2001 and 2010. p16INK4a immunohistochemistry was performed as a marker for human papillomavirus-related adenocarcinoma.

Results

Thirteen patients received radiotherapy and 19 patients underwent radical hysterectomy. The cumulative 3-year locoregional control rates in the radical hysterectomy and radiotherapy groups were 79.0 and 46.2 % (P = 0.03), and 5-year overall survival rates were 70.7 and 38.5 % (P = 0.09), respectively. Of patients with p16INK4a-positive tumors (n = 19), the cumulative 3-year locoregional control rates in the radical hysterectomy and radiotherapy groups were 100 and 60.0 % (P = 0.01), and 5-year overall survival rates were 88.9 and 40.0 % (P = 0.04), respectively. Conversely, the cumulative 3-year locoregional control rates in the human papillomavirus-negative radical hysterectomy group and radiotherapy group were 20.0 and 37.5 % (P = 0.66), and 5-year overall survival rates were 20.0 and 37.5 % (P = 0.60), respectively.

Conclusions

Radical hysterectomy may significantly improve locoregional control and overall survival compared with radiotherapy for stage IB2–IIB mucinous adenocarcinoma patients, especially those with p16INK4a-positive mucinous adenocarcinoma.

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Acknowledgments

This study was supported in part by the Health and Labour Sciences Research Expenses for Commission, Applied Research for Innovative Treatment of Cancer from the Ministry of Health, Labour and Welfare, H26-Innovative cancer-General-049.

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Authors and Affiliations

  1. Department of Gynecologic Oncology, Shikoku Cancer Center, 160 Minamiumemoto, Matsuyama, Ehime, 791-0280, Japan

    Shinichi Okame, Yuko Shiroyama, Takashi Yokoyama, Kazuhiro Takehara & Takayoshi Nogawa

  2. Department of Obstetrics and Gynecology, Iwate Medical University, 19-1 Uchimaru, Morioka, Iwate, 020-8505, Japan

    Atsumi Kojima

  3. Department of Pathology, Shikoku Cancer, 160 Minamiumemoto, Matsuyama, Ehime, 791-0280, Japan

    Norihiro Teramoto

Authors
  1. Shinichi Okame
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  2. Atsumi Kojima
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  3. Norihiro Teramoto
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  4. Yuko Shiroyama
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  6. Kazuhiro Takehara
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  7. Takayoshi Nogawa
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Correspondence to Shinichi Okame.

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The authors declare that they have no conflict of interest.

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Okame, S., Kojima, A., Teramoto, N. et al. Type C2 radical hysterectomy may improve outcomes of locally advanced mucinous adenocarcinoma of the uterine cervix. Int J Clin Oncol 21, 723–729 (2016). https://doi.org/10.1007/s10147-015-0939-8

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  • DOI: https://doi.org/10.1007/s10147-015-0939-8

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