• Nae-Fang Twu, Yu-Che Ou, Cheng-I Liao, Wei-Yang Chang, Lan-Yan Yang, Yun-Hsin Tang, Tze-Chien Chen, Chi-Hau Chen, Tze-Ho Chen, Lain-Shung Yeh, Shih-Tien Hsu, Yu-Chieh Chen, Cheng-Chang Chang, Ya-Min Cheng, Chia-Yen Huang, Fu-Shing Liu, Yue-Shan Lin, Sheng-Mou Hsiao, Yuan-Yee Kan, and Chyong-Huey Lai.
• Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, National Yang-Ming University, Taipei, Taiwan.
• Surg Oncol. 2016 Sep 1; 25 (3): 229-35.

ObjectiveWe aimed to identify prognostic factors of early-stage cervical adenocarcinoma (AC) and adenosquamous carcinoma (ASC) treated with primary radical surgery, and to evaluate the impact of postoperative adjuvant therapy on outcome.MethodsThe clinical-pathological data of all patients (n = 1132) with stages I-II cervical AC/ASC treated with primary radical surgery at the member hospitals of the Taiwanese Gynecologic Oncology Group were retrospectively reviewed.ResultsIn multivariate analysis, stage II, deep stromal invasion (DSI), lymphovascular space invasion (LVSI), positive pelvic lymph node (PLN), and parametrial involvement (PI) were significant factors for recurrence-free survival (RFS), while only DSI, PI, and positive PLN were independent factors for cancer-specific survival (CSS). Low- and high-risk groups were defined by prognostic scores derived from the four factors (DSI, LVSI, positive PLN, PI) selected by internal validation. Postoperative adjuvant therapy significantly improved outcome for PLN-positive patients (RFS, p = 0.014; CSS, p = 0.016), but not for PLN-negative high-risk group because of higher mean prognostic score (p = 0.028) of adjuvant+ than adjuvant- patients.ConclusionsPLN metastasis, PI, DSI, and LVSI were independent prognostic factors. Prospective studies of postoperative adjuvant therapy with prognostic score and nodal status stratification for cervical AC/ASC are necessary.Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

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