Gastric-type adenocarcinoma of the endocervix: Potentially overcoming resistant behavior with surgery.
Adenocarcinoma
Cervical cancer
Gynecologic cancer
Oncologic surgery
Radiation therapy
Uterine Cervical Neoplasms
Journal
Gynecologic oncology reports
ISSN: 2352-5789
Titre abrégé: Gynecol Oncol Rep
Pays: Netherlands
ID NLM: 101652231
Informations de publication
Date de publication:
Dec 2023
Dec 2023
Historique:
received:
10
08
2023
revised:
15
09
2023
accepted:
25
09
2023
medline:
16
10
2023
pubmed:
16
10
2023
entrez:
16
10
2023
Statut:
epublish
Résumé
Gastric-type adenocarcinoma of the endocervix (GAS) is a rare form of human papillomavirus-independent cervical cancer commonly described as an insidious disease bearing a poor prognosis. Based on scarce data, uncertainty persists pertaining to its oncologic management. All cases of well-differentiated GAS treated at our institution from 2010 to 2021 were reviewed. Clinical characteristics, diagnostic tests results and oncologic outcomes were recorded and analyzed. Kaplan-Meier curves and log rank test were performed to compare survival curves between patients with tumors confined to the cervix (group 1: up to stage IB3) versus locally advanced or metastatic (group 2: stages II to IV). Cervical cytologies and biopsies yielded low detection rates (38 and 42% respectively) leading to 87% of patients with locally advanced or metastatic disease at diagnosis. Median overall survival (OS) was 40.0 ± 15.9 months with a clear dichotomy in survival when comparing patients with disease confined to the cervix to those with higher stages (respectively 59.0 vs 12.0 months, p = 0.047). None of the 5 patients initially managed with concurrent chemoradiotherapy (CCRT) responded to treatment but fortunately 3 of the latter achieved remission after surgery. Well-differentiated GAS did not show favorable response to chemotherapy and radiation. Surgical resection seems to be a cornerstone in the management of this disease, as all patients who achieved remission were treated with surgery, either upfront or after suboptimal response to CCRT. We suggest considering aggressive upfront surgery when feasible. If CCRT is selected to avoid upfront exenterative procedures, rapid evaluation of tumor response is recommended.
Identifiants
pubmed: 37840972
doi: 10.1016/j.gore.2023.101282
pii: S2352-5789(23)00299-0
pmc: PMC10570569
doi:
Types de publication
Journal Article
Langues
eng
Pagination
101282Informations de copyright
© 2023 The Author(s).
Déclaration de conflit d'intérêts
The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
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