Does histologic type correlate to outcome after pelvic exenteration for cervical and vaginal cancer?

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.

• Authors: Glauco Baiocchi, Gustavo Cardoso Guimaraes, Carlos Chaves Faloppa, Lillian Yuri Kumagai, Renato Almeida Rosa Oliveira, Maria Dirlei Begnami, Fernando Augusto Soares, Ademar Lopes
• Journal: Annals of surgical oncology (Ann Surg Oncol) Vol. 20 Issue 5 Pg. 1694-700 (May 2013) ISSN: 1534-4681 [Electronic] United States
• PMID: 23212765 (Publication Type: Journal Article)

Topics

• Adenocarcinoma (pathology, secondary, surgery)
• Adult
• Aged
• Aged, 80 and over
• Blood Transfusion
• Carcinoma, Squamous Cell (pathology, secondary, surgery)
• Disease-Free Survival
• Female
• Follow-Up Studies
• Humans
• Length of Stay
• Lymphatic Metastasis
• Middle Aged
• Neoplasm Grading
• Neoplasm Invasiveness
• Neoplasm, Residual
• Operative Time
• Pelvic Exenteration
• Retrospective Studies
• Survival Rate
• Treatment Outcome
• Uterine Cervical Neoplasms (pathology, surgery)
• Vaginal Neoplasms (pathology, surgery)