Prognostic factors affecting cervical adenocarcinoma: 10 years experience in a single institution

• Published in: Archives of gynecology and obstetrics 2015-10, Vol.292 (4), p.915-921
• Main Authors: Khalil, J., Bellefqih, S., Afif, M., Elkacemi, H., Kebdani, T., Benjaafar, N.
• Format: Article
• Language: English
• Subjects: Adenocarcinoma - complications; Adenocarcinoma - pathology; Adenocarcinoma - radiotherapy; Adenocarcinoma - surgery; Adult; Aged; Cervical cancer; Endocrinology; Endometrial Neoplasms - pathology; Female; Gynecologic Oncology; Gynecology; Human Genetics; Humans; Kaplan-Meier Estimate; Lymphatic Metastasis; Lymphatic system; Medical prognosis; Medicine; Medicine & Public Health; Middle Aged; Morocco; Multivariate Analysis; Neoplasm Staging; Obstetrics/Perinatology/Midwifery; Population Surveillance; Population-based studies; Prognosis; Retrospective Studies; Survival Rate; Treatment Outcome; Uterine Cervical Neoplasms - complications; Uterine Cervical Neoplasms - pathology; Uterine Cervical Neoplasms - radiotherapy; Uterine Cervical Neoplasms - surgery; Young Adult
• ISSN: 0932-0067; 1432-0711
• DOI: 10.1007/s00404-015-3701-6

Objectives We performed a population-based study to determine the significance of adenocarcinoma and to evaluate its behavior over the last 10 years among patients treated in the National cancer institute of Morocco. Study design This is a retrospective study that was conducted in the national cancer institute of Morocco. Over a period of 10 years, we retrieved 350 cases of cervical invasive adenocarcinoma. Survival was analyzed according to the Kaplan–Meier method. A univariate analysis of prognostic factors was performed using the test of log rank. Cox regression model was used for the multivariate analysis of prognostic factors. Results Mean age at presentation was 46 years. Sixty seven percent of the patients had locally advanced stage. Radiotherapy was prescribed in 73.3 % of the cases. The mean follow-up time for surviving patients was 51 months. The 5-year survival rates according to clinical stages were as follows, 76 and 62 % for stages I and II, respectively, 32 and 9 % for stages III and IV, respectively. Tumor stage, tumor grade, positive lymph nodes status, lymphovascular space involvement and patient’s age were significant prognostic factors in a univariate analysis. While only stage and lymph node involvement remained significant independent predictors for survival in the multivariate analysis. Conclusion Although in our country incidence of adenocarcinoma is lower than the ones reported in western countries, in general our results are consistent with those reported in the literature. Better outcomes are observed in both early stages and young patients. Also, we found that FIGO stage, grade and lymph node metastases to be significant prognostic factors for survival in cervical adenocarcinoma.