Objective: To assess prognostic factors in patients with cervical adenocarcinoma.
Methods: Totally 159 cases of primary cervical adenocarcinoma were diagnosed in Cancer Hospital, Peking Union Medical College between 1992 and 2002. Clinical and pathological data including patients'age, delivery, tumor size, stage, grade, histological subtype, Pap smear, serum CA125 and treatment were reviewed. Mean age at presentation was 51.4 years. And the mean follow-up time was 59.8 months. According to the International Federation of Gynecology and Obstetrics (FIGO), patients with stages I-IV accounted for 13.2%, 34.0%, 45.3% and 7.5%, respectively. Survival analysis was carried out using SPSS software version 11.0.
Results: The overall 5-year survival rate was 47.9%. It was 86.1%, 56.4%, 36.0% and 0 for stages I, II, III and IV respectively. And 29.6% cases experienced recurrence or distant metastasis. The 5-year survival rate for them was 17.3%. In univariate analysis, tumor size (P = 0.009), stage (P < 0.01) and elevated serum CA125 values (P = 0.039) were significant factors for survival. In the group of 27 cases who received surgery, the survival was significantly poorer for cases with pelvic lymph node metastases (P = 0.001) and deep stromal invasion (P = 0.009). Only stage and pelvic lymph node metastases remained significant predictors for survival when multivariate analysis was performed.
Conclusions: This retrospective study suggests that FIGO stage and pelvic lymph node metastasis are independent factors in prediction of survival in cervical adenocarcinoma. Survival rate remains to be improved.