Survival And Clinicpathologic Characteristics Of Invasive Adenocarcinoma Of The Uterine Cervix

16559 Background: Carcinoma of the uterine cervix is one of the most common malignancies among women. The relative proportion and absolute incidence of cervical adenocarcinoma (AC) compared with squamous cell carcinoma (SCC) has increased; in the 1950s 5% of all cervical carcinomas were adenocarcinoma, in the 1990s this proportion increased to 25%. It remains controversial whether or not patients with adenocarcinoma have a worse prognosis; questions remain about whether cervical adenocarcinoma metastasizes earlier or is detected later by the cervical Papanicolaou test, or whether a poorer response to radiotherapy or the inclusion of special subtypes (such as clear cell carcinoma, which is known for its dismal prognosis) could account for an apparent poorer prognosis. Methods: This retrospective study was done in the Clinical Oncology Department of the Brazilian National Cancer Institute with 278 cases of primary AC of the uterine cervix diagnosed between 2002 and 2004. Clinical and pathological data were reviewed; survival was analyzed according to the Kaplan- Meier method. Results: Median age at presentation was 48 years; 50,4% of the patients were married and 66,9% were white. On histologic evaluation pure adenocarcinoma was found in 80,9% of the cases (n = 225), adenosquamous carcinoma in 14,4% (n = 40), clear cell carcinoma in 2,9% (n = 8) and other variants in 1,8% (n = 5). At diagnosis anemia was found in 29,5% of the patients, but 61,5% had metrorrhagia; 6,8% had hydronephrosis and 7,6% had high creatinine levels. Using FIGO stage 38,8% were stage I, 38,8% stage II, 17,9% stage III and 4,5% stage IV. Surgical treatment was used in 93 cases, radiochemotherapy combination in 69 cases and brachitherapy 129 cases. The median survival time was 34,9 months; 1-year, 3-year and 5-year overall survival rates were 81,2%; 67,2% and 54% respectively. The median survival time for the FIGO stage I, II, III and IV was 38,1; 35,4; 18,5 and 3,6 months. Conclusions: Adenocarcinomas are becoming more common, this report shows a similar survival to that found in previous reports and demonstrates a high rate of early FIGO stages. No significant financial relationships to disclose.