PROGNOSTIC FACTORS OF THE UTERINE CERVIX ADENOCARCINOMA

Background: Prognosis factors for adenocarcinoma of the uterine cervix after primary treatment are poorly established. Methods: A retrospect ive study of 45 cases of adenocarcinoma of the cervix with a follow-up of 96 months on average was performed. The primary treatment consiste d in combined radical surgery and radiotherapy for stage I-II patients while patients with advanced disease were treated by radiotherapy. In case of poor prognosis factors, they were given chemotherapy. Surviva l rates were established and prognosis factors influencing survival an d recurrences were studied. Results: Fifteen women remained alive with out evolutive disease. FIGO stage and pelvic node involvement were the most important parameters influencing overall survival. Local failure s (27%, average period of 30 months) were unpredictable and led to a d ramatic outcome. Histological grade and pelvic node status were signif icant predictive factors for metastatic recurrence (40%, average perio d of 29 months). Conclusions: Local recurrence and metastatic dissemin ation of cervical adenocarcinoma after primary treatment prove to be r apidly fatal although life expectancy can be prolonged with adjuvant t reatment of the recurrence. In the event of aggressive tumors with hig h histological grade and pelvic node involvement, an attempt to assess adjuvant systemic chemotherapy could be useful. (C) 1998 Elsevier Sci ence Ireland Ltd. All rights reserved.