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Gastric-type adenocarcinoma of the cervix: Clinical outcomes and genomic drivers

医学 内科学 腺癌 宫颈癌 阶段(地层学) 化疗 癌症 子宫颈 肿瘤科 子宫切除术 单中心 外科 胃肠病学 生物 古生物学
作者
Sarah Ehmann,Dib Sassine,Alli Straubhar,Aaron Praiss,Carol Aghajanian,Kaled M. Alektiar,Vance Broach,Karen A. Cadoo,Elizabeth L. Jewell,Amir Momeni Boroujeni,Chrisann Kyi,Mario M. Leitão,Jennifer J. Mueller,Rajmohan Murali,Shirin Issa Bhaloo,Roisin E. O’Cearbhaill,Kay J. Park,Yukio Sonoda,Britta Weigelt,Dmitriy Zamarin
出处
期刊:Gynecologic Oncology [Elsevier BV]
卷期号:167 (3): 458-466 被引量:24
标识
DOI:10.1016/j.ygyno.2022.10.003
摘要

Gastric-type endocervical adenocarcinoma (GEA) is a rare form of cervical cancer not associated with human papilloma virus (HPV) infection. We summarize our experience with GEA at a large cancer center.Clinical and demographic information on all patients diagnosed with GEA between June 1, 2002 and July 1, 2019 was obtained retrospectively from clinical charts. Kaplan-Meier survival analysis was performed to describe progression-free survival (PFS) and overall survival (OS). Tumors from a subset of patients underwent next generation sequencing (NGS) analysis.A total of 70 women with GEA were identified, including 43 who received initial treatment at our institution: of these 4 (9%) underwent surgery alone, 15 (35%) underwent surgery followed by adjuvant therapy, 10 (23%) were treated with definitive concurrent chemoradiation (CCRT), 7 (16%) with chemotherapy alone, and 3 (7%) with neoadjuvant CCRT and hysterectomy with or without chemotherapy. One-third (n = 14) of patients experienced disease progression, of whom 86% (n = 12) had prior CCRT. The median PFS and OS for patients with stage I GEA were 107 months (95% CI 14.8-199.2 months) and 111 months (95% CI 17-205.1 months) respectively, compared to 17 months (95% CI 5.6-28.4 months) and 33 months (95% CI 28.2-37.8 months) for patients with stages II-IV, respectively. On NGS, 4 patients (14%) had ERBB2 alterations, including 2 patients who received trastuzumab.GEA is an aggressive form of cervical cancer with poor PFS and OS when diagnosed at stage II or later. Further investigation is needed to identify the optimal management approach for this rare subtype.
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