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The Updated WHO Classification Better Predicts Survival in Patients with Endocervical Adenocarcinoma (KROG 20-07)

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Author(s)
Won Kyung ChoHyun-Soo KimWon ParkYeon-Sil KimJun KangYong Bae KimYoung Seok KimYeon Joo KimKyu-Rae KimJin Hee KimSun Young KwonJin Hwa ChoiMeesun YoonNah Ihm Kim
Keimyung Author(s)
Kim, Jin HeeKwon, Sun Young
Department
Dept. of Radiation Oncology (방사선종양학)
Dept. of Pathology (병리학)
Journal Title
Int J Radiat Oncol Biol Phys
Issued Date
2023
Volume
117
Issue
1
Abstract
Purpose:
The 2020 World Health Organization classification divided endocervical adenocarcinoma (ADC) into human papillomavirus-associated (HPVA) and human papillomavirus-independent (HPVI) ADCs. This multi-institutional study aimed to investigate the clinical features and prognosis of patients with endocervical ADC based on the updated World Health Organization classification.

Methods and materials:
We retrospectively reviewed the 365 patients with endocervical ADC who underwent radical hysterectomy from 7 institutions. Tumor characteristics, patterns of failure, and survival outcomes were compared between HPVA and HPVI ADCs.

Results:
Two hundred seventy-five (75.3%) and 90 (24.7%) patients had HPVA and HPVI ADC diagnoses, respectively. In all cases, the 5-year disease-free survival (DFS) and overall survival (OS) rates were 58.2% and 71.3%, respectively. HPVI ADC showed higher rates of local recurrence (25.6% vs 10.9%) and distant metastasis (33.3% vs 17.5%) than HPVA ADC. Multivariate survival analysis revealed that HPVI ADC showed significantly worse DFS (hazard ratio [HR], 1.919; 95% confidence interval [CI], 1.324-2.781; P < .001), distant metastasis-free survival (HR, 2.100; 95% CI, 1.397-3.156; P < .001), and OS (HR, 2.481; 95% CI, 1.586-3.881; P < .001) than HPVA ADC. Patients with gastric- and serous-type HPVI ADC had significantly worse OS than those with other HPVI ADCs (P = .020). Similarly, invasive stratified mucin-producing-type HPVA ADC showed significantly worse OS than other HPVA ADCs (P < .001).

Conclusions:
We demonstrated that HPVI ADC exhibited inferior DFS and OS and higher rates of local and distant recurrence compared with HPVA ADC. Gastric- and serous-type HPVI ADCs and invasive stratified mucin-producing-type HPVA ADC showed worse OS than other types of HPVI and HPVA ADCs, respectively. Our observation of significant differences in prognoses according to the histologic types needs to be validated in larger cohorts of patients with endocervical ADC.
Keimyung Author(s)(Kor)
김진희
권선영
Publisher
School of Medicine (의과대학)
Type
Article
ISSN
1879-355X
Source
https://www.clinicalkey.com/#!/content/playContent/1-s2.0-S0360301623002882
DOI
10.1016/j.ijrobp.2023.03.048
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/45114
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Pathology (병리학)
1. School of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학)
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