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The prognosis of adenosquamous carcinomas of the uterine cervix
Author(s) -
BETHWAITE PETER,
YEONG MEE LING,
HOLLOWAY LINDA,
ROBSON BRIDGET,
DUNCAN GRAEME,
LAMB DAVID
Publication year - 1992
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/j.1471-0528.1992.tb13877.x
Subject(s) - adenosquamous carcinoma , medicine , cervix , mucin , oncology , cohort , pathology , stage (stratigraphy) , metastasis , cancer , adenocarcinoma , biology , paleontology
Objectives Firstly, to identify a cohort of women with invasive adenosquamous carcinomas of the uterine cervix, including mucin‐producing squamous cell carcinomas. Secondly, to compare the biological characteristics and behaviour of a cohort of adenosquamous carcinomas with a cohort of non‐mucin‐producing squamous cell carcinomas. Design Histological review, retrospective survival analysis. Setting Regional multidisciplinary gynaecological oncology service. Subjects 161 cases of stage 1B and above invasive cervical carcinoma presenting between 1 January 1980 and 31 July 1987. Thirty nine women with adenosquamous carcinomas were compared with 103 women with non‐mucin‐producing squamous cell tumours. Results Inclusion of routine stains for mucin in the assessment of histological material resulted in the reclassification of 38 (24%) of the cases, including the identification of 31 mucin‐producing squamous cell carcinomas. The survival with adenosquamous tumours was significantly worse than with squamous cell cancers ( P = 0.006 ), 5‐year survival rates being 52% and 75% respectively. Multivariate analysis showed that this effect was explained by differences in clinical stage, pelvic lymph node metastasis and vascular invasion by tumour. Conclusions The application of routine mucin stains to cervical tumours identifies a group of previously unrecognized adenosquamous cancers. Tumours so identified are likely to pursue a more aggressive clinical course associated with a poorer survial when compared to non‐mucin‐producing squamous carcinomas.