Prognostic factors of adenocarcinoma of the uterine cervix

Objective. The prognostic importance of adenocarcinoma of the uterine cervi x was investigated. Methods. One hundred ninety-three patients (144 had stage I disease, 41 sta ge II, and 8 stage III-TV) with invasive adenocarcinoma of the uterine cerv ix treated initially at the Aichi Cancer Center between 1964 and 1995 were studied. Results. Of all the invasive cervical cancers, 8.8% were adenocarcinomas th at had been increasing during the past decade, The overall 5-year survival for stage I was 88.8%, stage II 44.9%, and stage III-IV 0% In univariate an alysis, the clinicopathological factors associated with overall survival an d disease-free survival were age of patient, stage of disease, presence of nodal metastasis, number of lymph nodes involved, lymph-vascular space inva sion, tumor size, and intraperitoneal metastasis. Multivariate analysis per formed in all cases identified the clinical stage of disease, the presence of nodal metastasis, number of lymph nodes involved, lymph-vascular space i nvasion, and tumor size as the independent risk factors for recurrence and survival. In the analysis of stage I disease, lymph node metastasis and tum or size were the significant prognostic factors, while lymph-vascular space invasion and tumor size were the factors in advanced disease. Tumor grade and histological type were not associated with recurrence and survival. Conclusion. These results suggested the association of lymph node metastasi s with the prognosis of early stage adenocarcinoma of the uterine cervix an d lymph-vascular space invasion with the advanced stage. Tumor size was an independent risk factor throughout all stages. (C) 1999 Academic Press.