Comparison of survival outcomes between squamous cell carcinoma and adenocarcinoma/adenosquamous carcinoma of the cervix after radical radiotherapy and chemotherapy
Ping Liu,
Mei Ji,
Yanxiang Kong,
Zhifeng Huo,
Qiubo Lv,
Qinghuang Xie,
Danbo Wang,
Biliang Chen,
Hailin Wang,
Zhumei Cui,
Qianqing Wang,
Xiaonong Bin,
Jinghe Lang,
Chunlin Chen
Affiliations
Ping Liu
Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University
Mei Ji
Department of Obstetrics and Gynecology, The First Affiliated Hospital of Zhengzhou University
Yanxiang Kong
Department of Reproductive Medicine, The Seventh Affiliated Hospital Sun Yat-Sen University
Zhifeng Huo
Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University
Qiubo Lv
Department of Obstetrics and Gynecology, Beijing Hospital, National Center of Gerontology
Qinghuang Xie
Foshan Maternal and Child Health Hospital
Danbo Wang
Department of Gynaecology, Liaoning Cancer Hospital
Biliang Chen
Department of Obstetrics and Gynecology, Xijing Hospital of Airforce Medical University
Hailin Wang
Department of Obstetrics and Gynecology, Gansu Provincial Hospital
Zhumei Cui
Department of Gynaecology, The Affiliated Hospital of Qingdao University
Qianqing Wang
Gynecologic Oncology Department, Xinxiang City Central Hospital in Henan Province
Xiaonong Bin
Department of Epidemiology, College of Public Health, Guangzhou Medical University
Jinghe Lang
Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University
Chunlin Chen
Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University
Abstract Background This study aimed to compare the survival outcomes between squamous cell carcinoma (SCC) and adenocarcinoma/adenosquamous carcinoma (AC/ASC) of the cervix after radical radiotherapy and chemotherapy. Methods Propensity score matching (1:4) was used to compare overall survival (OS) and disease-free survival (DFS) in cervical cancer patients with SCC and AC/ASC in China. Results Five thousand four hundred sixty-six patients were enrolled according to the criteria. The 5-year OS and DFS in the SCC group (n = 5251) were higher than those in the AC/ASC group (n = 215). After PSM (1:4), the 5-year OS and DFS in the SCC group were higher than those in the AC/ASC group (72.2% vs 56.9%, p < 0.001, HR = 1.895; 67.6% vs 47.8%, p < 0.001, HR = 2.056). In stage I-IIA2 patients, after PSM (1:4), there was no significant difference in 5-year OS between the SCC group (n = 143) and the AC/ASC group (n = 34) (68.5% vs 67.8%, P = 0.175). However, the 5-year DFS in the SCC group was higher than that in the AC/ASC group (71.0% vs 55.7%, P = 0.045; HR = 2.037, P = 0.033). In stage IIB-IV patients, after PSM (1:4), the 5-year OS and DFS in the SCC group (n = 690) were higher than those in the AC/ASC group (n = 173) (70.7% vs 54.3% P < 0.001 vs 1.940%, P < 0.001 vs 45.8%, p < 0.001). Conclusions For stage I-IIA2, there was no significant difference in 5-year survival time, but patients with AC/ASC were more likely to relapse. In the more advanced IIB-IV stage, the oncological outcome of radical radiotherapy and chemotherapy of cervical AC/ASC was worse than that of SCC.
