Survival Analysis and Proportion of Lymph Node Metastasis of Early-stage HPV-associated Endocervical Adenocarcinoma Based on Pattern
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Abstract
Objectives: To determine disease-free survival, disease-specific survival and lymph node metastasis in human papilloma virus (HPV) - associated cervical adenocarcinoma by pattern-based classification.
Materials and Methods: A total of 98 cases diagnosed with HPV-associated cervical adenocarcinoma that underwent pelvic lymph node dissection were retrospectively reviewed and reclassified according to the latest World Health Organization classification.
Results: Ninety-three were classified as usual-type adenocarcinoma (94.9%) and 5 (5.1%) as mucinous adenocarcinoma. 19 (19.4%), 32 (32.7%), and 47 (47.6%) cases as patterns A, B, and C, respectively. Lymph node metastasis was observed in 0% of pattern A tumors, 12.5% of pattern B tumors, and 31.9% of pattern C tumors. The 5-year disease-specific survival of patients with patterns A, B, and C tumors was 100%, 90.6%, and 63.8 %, respectively. The 5-year disease-free survival of patients with patterns A, B, and C tumors was 94.7%, 84.4%, and 57.4%, respectively. Patten C tumors were associated with worst disease-specific survival and disease-free survival: hazard ratio 8.82 (95% confidence interval (CI) 1.70 to 66.41) and 10.74 (95% CI 1.4 to 78.13), but the association disappeared after adjustment for clinicopathologic characteristics.
Conclusion: The 5-year disease-specific survival was 100% with no lymph node metastasis in patients with pattern A. Patients with pattern B and C are associated with higher risk of lymphovascular space invasion and lymph node metastasis.
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