Survival comparison between squamous cell carcinoma and adenocarcinoma for radiotherapy-treated patients with stage IIB-IVA cervical cancer

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Authors
Chen, Fangjie
Chen, Long
Zhang, Yu
Shi, Lei
Xu, Hong’en
Song, Tao
Issue Date
2022-07-22
Type
Article
Language
en_US
Keywords
Cervical Cancer , Squamous Cell Carcinoma , Adenocarcinoma , SEER , Survival
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Abstract
Objective: To compare the prognostic significance of adenocarcinoma (AC) with squamous cell carcinoma (SCC) on overall survival (OS) in patients with stage IIB-IVA cervical cancer (CC) treated by external beam radiotherapy (EBRT) and brachytherapy (BRT) with/without chemotherapy registered in the Surveillance, Epidemiology, and End Results database. Methods: Data of eligible patients were extracted between 2004 and 2016. A univariate analysis was conducted using the cumulative incidence function (CIF) by considering competing events and compared using Gray’s test. The significant variables in univariate analysis were further evaluated in a multivariate analysis performed with the Fine-Gray regression model. Propensity score matching (PSM) analysis was also employed to reconfirm the results found in the present study. Results: A total of 2,243 patients with SCC and 176 patients with AC were extracted from the database. The 5-year OS rates were 57.8% in the SCC group and 52.8% in the AC group. 149 patients died of causes other than CC—considered as competing events. Compared with the SCC group, patients diagnosed with AC had statistically significant worse 5-year OS rate before and after PSM. In the multivariate Fine-Gray regression model, the histological subtype of AC was proven as an independent prognostic factor associated with poorer OS before [hazard ratio (HR) = 1.340; 95% confidence interval (CI): 1.081-1.660; P = 0.007] and after [HR = 1.376; 95% CI: 1.107-1.711; P = 0.004] PSM. Conclusions: The histological subtype of AC is significantly correlated with impaired OS as an independent prognostic variable in patients with stage IIB-IVA CC who received EBRT and BRT compared to patients with SCC. Future studies should incorporate effective and individualized treatment strategies into clinical decision-making to improve the unsatisfactory survival outcomes for patients with AC.
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Chen, F., Chen, L., Zhang, Y., Shi, L., Xu, H., & Song, T. (2022). Survival Comparison Between Squamous Cell Carcinoma and Adenocarcinoma for Radiotherapy-Treated Patients with Stage IIB-IVA Cervical Cancer. Frontiers in oncology, 12, 895122. https://doi.org/10.3389/fonc.2022.895122
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Frontiers in Oncology
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