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Adenocarcinoma of the uterine cervix: Pathologic features, treatment options, clinical outcome and prognostic variables.
- Source :
-
Critical reviews in oncology/hematology [Crit Rev Oncol Hematol] 2019 Mar; Vol. 135, pp. 103-114. Date of Electronic Publication: 2019 Jan 19. - Publication Year :
- 2019
-
Abstract
- Adenocarcinoma accounts for 10-25% of all cervical cancers, and its relative and absolute rate has raised over the past decades. Most, but not all the authors, reported that adenocarcinoma has a greater propensity to lymph node, ovarian and distant metastases and a worse prognosis compared with squamous cell carcinoma. However, whether histologic type is an independent prognostic factor is still a debated issue. Moreover, adenocarcinoma is a very heterogenous disease, including different histological subtypes. Whereas radical hysterectomy and definitive radiotherapy achieve the same clinical outcome in early stage squamous cell carcinoma, surgery seems to obtain better survival compared with definitive radiotherapy in early stage adenocarcinoma. Chemoradiation is the standard treatment for locally advanced cervical cancer regardless of histologic type, although several retrospective studies showed that patients with adenocarcinoma were more likely to die than those with squamous cell carcinoma both before and after concurrent chemoradiation era. The prognostic relevance of biological variables, such as cyclin-dependent kinase inhibitors, p53, cyclooxygenase-2 [COX-2], cell surface tyrosine-kinases and programmed death-ligand [PD-L1], is still under investigation. Palliative chemotherapy is the only treatment option for persistent or recurrent cervical adenocarcinoma not amenable with surgery and radiotherapy. The use of immune checkpoint inhibitors as well as a therapeutic strategy targeting cell surface tyrosine kinases should be adequately explored in this clinical setting.<br /> (Copyright © 2019 Elsevier B.V. All rights reserved.)
- Subjects :
- Adult
Aged
Antineoplastic Agents therapeutic use
Combined Modality Therapy methods
Combined Modality Therapy mortality
Female
Humans
Hysterectomy methods
Hysterectomy mortality
Middle Aged
Prognosis
Radiotherapy methods
Radiotherapy mortality
Adenocarcinoma mortality
Adenocarcinoma pathology
Adenocarcinoma therapy
Uterine Cervical Neoplasms mortality
Uterine Cervical Neoplasms pathology
Uterine Cervical Neoplasms therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1879-0461
- Volume :
- 135
- Database :
- MEDLINE
- Journal :
- Critical reviews in oncology/hematology
- Publication Type :
- Academic Journal
- Accession number :
- 30819439
- Full Text :
- https://doi.org/10.1016/j.critrevonc.2019.01.006