Clear cell carcinoma of the uterine cervix: pathology and prognosis in surgically treated stage IB-IIB disease in women not exposed in utero to diethylstilbestrol.

Abstract

OBJECTIVE:

The purpose of this research was to compare the clinical behavior, pathology findings, and prognosis of surgically treated FIGO stage IB-IIB clear cell carcinomas of the cervix with those of squamous cell carcinomas and non-clear cell adenocarcinomas.

METHODS:

Fifteen patients with clear cell adenocarcinomas of the cervix (8 FIGO stage IB, 7 FIGO stage IIB) were reviewed. The control group consisted of 444 squamous cell carcinomas and 59 non-clear cell adenocarcinomas. None of the patients had a history of in utero exposure to diethylstilbestrol. All patients underwent radical abdominal hysterectomy with systematic pelvic lymphadenectomy. All specimens were processed as serial giant frontal sections. The mean follow-up in the clear cell group was 83 (13-182) months. Statistical analysis was done with contingency tables, chi(2) tests, and Fisher's exact test.

RESULTS:

Twelve of the fifteen clear cell carcinomas (80%) were endophytic and tended toward deep cervical infiltration. Clear cell carcinomas extended to the uterine corpus significantly more often than squamous cell and non-clear cell adenocarcarcinomas (P < 0.001). The rates of parametrial involvement and pelvic lymph node involvement were 40 and 47%, respectively. Four patients (27%), all with positive pelvic nodes, developed recurrences an average of 14 (4-48) months after initial therapy. The extrapelvic sites of relapse were the lung, liver, and bone. Clear cell carcinomas had a worse 5-year survival rate (67%) than squamous cell carcinomas (80%) and non-clear cell adenocarcinomas (77%) but this was not statistically significant (P = 0.6). No significant differences were seen for age, growth pattern, parametrial and vaginal involvement, parametrial and pelvic lymph node metastases, frequency of recurrent disease, and time to first recurrence.

CONCLUSION:

The clinicopathologic findings and prognosis of surgically treated patients with stage IB-IIB clear cell carcinomas without exposure to diethylstilbestrol in utero are similar to those of patients with squamous cell carcinomas and non-clear cell adenocarcinomas.

• Authors: O Reich, K Tamussino, M Lahousen, H Pickel, J Haas, R Winter
• Journal: Gynecologic oncology (Gynecol Oncol) Vol. 76 Issue 3 Pg. 331-5 (Mar 2000) ISSN: 0090-8258 [Print] United States
• PMID: 10684706 (Publication Type: Comparative Study, Journal Article)
• Copyright: Copyright 2000 Academic Press.

Chemical References

• Carcinogens
• Diethylstilbestrol

Topics

• Adenocarcinoma, Clear Cell (mortality, pathology, surgery)
• Adult
• Aged
• Carcinogens
• Carcinoma, Squamous Cell (mortality, pathology, surgery)
• Diethylstilbestrol
• Female
• Humans
• Lymphatic Metastasis
• Middle Aged
• Neoplasm Staging
• Prognosis
• Survival Analysis
• Uterine Cervical Neoplasms (mortality, pathology, surgery)