TY - JOUR
T1 - Analysis of gastric-type mucinous carcinoma of the uterine cervix — An aggressive tumor with a poor prognosis
T2 - A multi-institutional study
AU - Nishio, Shin
AU - Mikami, Yoshiki
AU - Tokunaga, Hideki
AU - Yaegashi, Nobuo
AU - Satoh, Toyomi
AU - Saito, Motoaki
AU - Okamoto, Aikou
AU - Kasamatsu, Takahiro
AU - Miyamoto, Tsutomu
AU - Shiozawa, Tanri
AU - Yoshioka, Yumiko
AU - Mandai, Masaki
AU - Kojima, Atsumi
AU - Takehara, Kazuhiro
AU - Kaneki, Eisuke
AU - Kobayashi, Hiroaki
AU - Kaku, Tsunehisa
AU - Ushijima, Kimio
AU - Kamura, Toshiharu
N1 - Funding Information:
This work was supported by the National Cancer Center Research and Development Fund of Japan [grant numbers 23-A-17 , 26-A-4 , 29-A-3 ].
Publisher Copyright:
© 2019 The Author(s)
PY - 2019/4
Y1 - 2019/4
N2 - Objective: Gastric-type mucinous carcinoma (GAS) is a novel variant of mucinous carcinoma of the uterine cervix. As shown in the original Japanese group description, in recent studies, GAS represents a more aggressive disease than the usual-type endocervical adenocarcinoma (UEA). Detailed clinicopathological features of this variant remain to be elucidated in a larger series of patients. Methods: Patients were enrolled by the Gynecologic Cancer Study Group of the Japan Clinical Oncology Group after receiving the approval of each Institutional Review Board. The study population comprised of women with stage I to II endocervical adenocarcinomas who underwent surgery between 2000 and 2009. Representative slides were evaluated by central pathological review (CPR), categorized into either GAS or UEA, and correlated with clinicopathological features and outcome. Results: Among the 393 enrolled patients with endocervical adenocarcinoma, 328 patients met the criteria for CPR and the study eligibility criteria and were included in further analysis. A total of 95 of the 328 tumors were classified as GAS. Compared with UEA, GAS was more significantly associated with bulky mass, deep stromal invasion, lymphovascular space invasion, parametrial invasion, ovarian metastasis, positive ascitic fluid cytology, pelvic lymph node metastasis, and pathological (p) T stage but was not related to the degree of histological differentiation. Disease-free survival (P < 0.0001) and overall survival (P < 0.0001) were poorer in patients with GAS than in those with UEA. Conclusions: GAS showed aggressive behavior with ominous histopathological predictors as well as decreased survival. GAS is therefore considered a distinct entity that should be distinguished from UEA. Clinical trial information: UMIN Clinical Trials Registry: UMIN000007987
AB - Objective: Gastric-type mucinous carcinoma (GAS) is a novel variant of mucinous carcinoma of the uterine cervix. As shown in the original Japanese group description, in recent studies, GAS represents a more aggressive disease than the usual-type endocervical adenocarcinoma (UEA). Detailed clinicopathological features of this variant remain to be elucidated in a larger series of patients. Methods: Patients were enrolled by the Gynecologic Cancer Study Group of the Japan Clinical Oncology Group after receiving the approval of each Institutional Review Board. The study population comprised of women with stage I to II endocervical adenocarcinomas who underwent surgery between 2000 and 2009. Representative slides were evaluated by central pathological review (CPR), categorized into either GAS or UEA, and correlated with clinicopathological features and outcome. Results: Among the 393 enrolled patients with endocervical adenocarcinoma, 328 patients met the criteria for CPR and the study eligibility criteria and were included in further analysis. A total of 95 of the 328 tumors were classified as GAS. Compared with UEA, GAS was more significantly associated with bulky mass, deep stromal invasion, lymphovascular space invasion, parametrial invasion, ovarian metastasis, positive ascitic fluid cytology, pelvic lymph node metastasis, and pathological (p) T stage but was not related to the degree of histological differentiation. Disease-free survival (P < 0.0001) and overall survival (P < 0.0001) were poorer in patients with GAS than in those with UEA. Conclusions: GAS showed aggressive behavior with ominous histopathological predictors as well as decreased survival. GAS is therefore considered a distinct entity that should be distinguished from UEA. Clinical trial information: UMIN Clinical Trials Registry: UMIN000007987
KW - Aggressive tumor
KW - Gastric-type mucinous carcinoma
KW - Large series
KW - Usual-type endocervical adenocarcinoma
KW - Uterine cervical cancer
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U2 - 10.1016/j.ygyno.2019.01.022
DO - 10.1016/j.ygyno.2019.01.022
M3 - Article
C2 - 30709650
AN - SCOPUS:85060627725
SN - 0090-8258
VL - 153
SP - 13
EP - 19
JO - Gynecologic Oncology
JF - Gynecologic Oncology
IS - 1
ER -
