In the past decade, the incidence of
adenocarcinoma of the uterine cervix gradually increased. Recent literature revealed that the molecular pathogenesis differs by histological subtype, and the histological subtype should be considered in deciding treatments for patients with
uterine cervical cancer. However, no treatment based on histological type or genomic signature has been recommended in various treatment guidelines. The Japanese treatment guidelines recommend either radical
hysterectomy or definitive
radiotherapy as primary treatment for patients with stage IB-IIB
squamous cell carcinoma and a radical
hysterectomy-based approach for those with non-
squamous cell carcinoma because of its lower radiosensitivity. The impact of histological type on survival outcome of
uterine cervical cancer is controversial. Our retrospective studies suggested that the difference in survival outcome by histological subtype might be remarkable with
disease progression. Recent literature suggested that usual-type endocervical
adenocarcinoma, which is the most common histological type of cervical
adenocarcinoma, showed a similar survival outcome to
squamous cell carcinoma. In contrast, gastric-type
mucinous carcinoma of the uterine cervix, which has aggressive clinical behavior and is not associated with high-risk
human papillomavirus infection, showed resistance to
chemotherapy and
radiotherapy. Importantly, gastric-type
mucinous carcinoma is rather common in Japan, compared with Western countries. It is therefore conceivable that the survival outcome of non-
squamous cell carcinoma may be affected by regional difference in the frequency of gastric-type
mucinous carcinoma. A molecular target to refractory
uterine cervical cancer, such as gastric-type
mucinous carcinoma of uterine cervix, still remains to be identified.