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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: February 2014 - Volume 24 - Issue 2 - p 289–294
doi: 10.1097/IGC.0000000000000063
Cervical Cancer

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.

Supplemental digital content is available in the text.

*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:

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

The authors declare no conflicts of interest.

Supplemental digital content is available for this article. Direct URL citation appears in the printed text and is provided in the HTML and PDF versions of this article on the journal’s Web site (

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.