Prognostic Factors of Adenocarcinoma of the Endocervix: Pattern of Invasion vs Depth of Invasion
I Aguilera-Barrantes, EG Silva. M.D.Anderson Cancer Center, Houston, TX
Background: The treatment of endocervical adenocarcinoma (EA) depends primarily on the depth of invasion. The grade of the tumor is typically considered a less important prognostic factor and the pattern of invasion has not been evaluated. The purpose of our study is to evaluate whether these features impact prognosis.
Design: We reviewed 43 cases of invasive adenocarcinoma of the endocervix seen at our institution. For each case 1 to 49 slides (median 9) of cone/ LEEP and/or hysterectomy specimens were available for review. Follow up (FU) was obtained in all cases. These cases were divided in two groups. One group with pushing border (PB) of invasion or PB with focal infiltration (defined as 1 or 2 foci of infiltration) and the other group with diffuse infiltration (DI) of the stroma. Tumors were graded observing only architectural features and were classified as well differentiated (WD) if composed only of glands, moderated differentiated (MD) composed of glands and solid tumor and poorly differentiated (PD) predominantly solid.
Results: Patient ages ranged 25 to 58 (mean 39). The follow up for those who survived ranged from 37 to 250 months (median 94 months). A summary of the results for all patients is in table 1.
|Pattern of invasion||n||Depth mm||Grade||LVI||LN Mets||FU||TX|
|PB||22||1 to 14 (median 5.5)||21/22 WD; 1/21 MD||1/22||0/15||22/22 NED||5/22|
|DI||21||2 to 14 (median 5)||10/21 WD; 8/21 MD; 3/21 PD||13/21||6/18||8/21 DOD; 2/21 AWD; 11/21 NED||11/21|
|P value||0.0006 (WD)||<0.0001||0.0213||0.0002 (NED)|