Prognosis of Adenosquamous Carcinoma Compared With Adenocarcinoma in Uterine Cervical Cancer: A Systematic Review and Meta-Analysis of Observational Studies

Lee, Jung-Yun MD*; Lee, Chulmin MD, PhD; Hahn, SeoKyung PhD; Kim, Min A. MD, PhD§; Kim, Hee Seung MD*; Chung, Hyun Hoon MD, PhD*; Kim, Jae-Weon MD, PhD*; Park, Noh Hyun MD, PhD*; Song, Yong-Sang MD, PhD*

International Journal of Gynecological Cancer:
doi: 10.1097/IGC.0000000000000063
Cervical Cancer
Abstract

Objective: The aim of this study was to compare the survival outcomes of adenosquamous carcinoma (ASC) and adenocarcinoma (AC) of the cervix.

Methods: We searched PubMed and Embase for observational studies that compared the outcomes of 2 histologic subtypes. Hazards ratios (HRs) with 95% confidence intervals (CIs) were calculated with a fixed effects model.

Results: A total of 17 studies were included in the analyses. Patients with ASC were associated significantly with poorer overall survival (death HR, 1.27; 95% CI, 1.12–1.43; I2 = 0%) and recurrence-free survival (recurrence HR, 1.43; 95% CI, 1.05–1.95; I2 = 19.4%) than those with AC. For clinical stages I and II in particular, ASC predicted significantly poorer outcomes compared with AC (death HR, 1.41; 95% CI, 1.17–1.70; I2 = 0%).

Conclusions: This meta-analysis suggests that ASC may have poorer outcomes compared with AC of the cervix.

Author Information

*Department of Obstetrics and Gynecology, College of Medicine, Seoul National University; †Department of Obstetrics and Gynecology, Inje University Sanggye Paik Hospital; and ‡Departments of Medicine, and §Pathology, Seoul National University College of Medicine, Seoul, Korea.

Address correspondence and reprint requests to Jae-Weon Kim, MD, PhD, Department of Obstetrics and Gynecology, College of Medicine, Seoul National University, 101 Daehak-ro, Jongno-gu, 110-744 Seoul, Korea. E-mail: kjwksh@snu.ac.kr.

This work was supported by Research Resettlement Fund for the new faculty of Seoul National University.

The authors declare no conflicts of interest.

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Received July 30, 2013

Received in revised form November 11, 2013

Accepted November 11, 2013

© 2014 by the International Gynecologic Cancer Society and the European Society of Gynaecological Oncology.