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Prognostic Factors Influencing Decisions About Surgical Treatment of Villoglandular Adenocarcinoma of the Uterine Cervix

Kim, Ha-Jeong MD*; Sung, Ji-Hee MD; Lee, Eunjung MD; Ahn, Soomin MD; Song, Sang Yong MD, PhD; Choi, Chel Hun MD; Kim, Tae-Joong MD; Kim, Byoung-Gie MD, PhD; Bae, Duk-Soo MD, PhD; Lee, Jeong-Won MD, PhD

International Journal of Gynecological Cancer: September 2014 - Volume 24 - Issue 7 - p 1299–1305
doi: 10.1097/IGC.0000000000000197
Cervical Cancer

Objective: The objectives of this study were to analyze the clinicopathologic features of villoglandular adenocarcinoma (VGA) of the uterine cervix, a variant of cervical adenocarcinoma with good prognosis, and to discuss the association of human papillomavirus (HPV) infection with VGA.

Methods: A retrospective review of medical records was performed to identify the patients with VGA between 1999 and 2007 at the Samsung Medical Center.

Results: Fifteen patients were identified among 171 women diagnosed with adenocarcinoma of the cervix. The median age was 40 years (range, 32–72 years). Four patients were treated by cone biopsy and 10 patients by hysterectomy with or without pelvic lymphadenectomy. Five patients had invasion of more than half of the depth of tumor in the cervix. Lymphovascular space invasion was present in 2 patients, one of whom also had lymph node metastases. Three recurrences were identified during the median follow-up of 64 months (range, 9–149 months). An HPV test was positive in 6 of 7 patients. Of the 6 patients with HPV infection, 2 were positive for HPV type 18, one for HPV type 6, and the remaining 3 were positive for 1 or more types of high-risk HPV.

Conclusions: Although VGA has been reported to have a favorable prognosis, we observed recurrences in those patients with close margins by the tumor, lymph node metastasis, or advanced stage. Human papillomavirus DNA, mostly HPV types 16 and 18, was associated with VGA. Further studies are warranted on prognostic factors and the pathogenetic role of HPV infections.

*Department of Obstetrics and Gynecology, Institute of Wonkwang Medical Science, College of Medicine, Wonkwang University, Iksan; Departments of †Obstetrics and Gynecology and ‡Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

H.-J.K. and J.-H.S. equally contributed to this article.

Address correspondence and reprint requests to Jeong-Won Lee, MD, PhD, Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 135-710, Korea. E-mail: garden.lee@samsung.com.

This study was supported by a grant from the Basic Science Research Program through the National Research Foundation of Korea, Ministry of Education, Republic of Korea (2013R1A1A2013612).

The authors declare no conflicts of interest.

Received March 13, 2014

Received in revised form May 8, 2014

Accepted May 8, 2014

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