Clear cell carcinoma (CCC) of the cervix is a human papillomavirus (HPV)-independent tumor associated with poor outcome: A comprehensive analysis of 58 cases Journal Article
| Authors: | Stolnicu, S.; Karpathiou, G.; Guerra, E.; Mateoiu, C.; Reques, A.; Garcia, A.; Bart, J.; Felix, A.; Fani, D.; Gama, J.; Hardisson, D.; Bennett, J. A.; Parra-Herran, C.; Oliva, E.; Abu-Rustum, N.; Soslow, R. A.; Park, K. J. |
| Article Title: | Clear cell carcinoma (CCC) of the cervix is a human papillomavirus (HPV)-independent tumor associated with poor outcome: A comprehensive analysis of 58 cases |
| Abstract: | Cervical clear cell carcinoma (CCC) is a rare human papillomavirus-independent adenocarcinoma. While recent studies have focused on gastric-type endocervical adenocarcinoma (GTA), little is known about CCC. A total of 58 (CCCs) were collected from 14 international institutions and retrospectively analyzed using univariable and multivariable methods and compared with 36 gastric-type adenocarcinomas and 173 human papillomavirus-associated (HPVA) endocervical adenocarcinoma (ECA) regarding overall survival (OS) and recurrence-free survival (RFS). Most cases were FIGO stage I (72.4%), with Silva C pattern of invasion (77.6%), and the majority were treated with radical surgery (84.5%) and adjuvant therapy (55.2%). Lymphovascular invasion was present in 31%, while lymph node metastasis was seen in 24.1%; 10.3% were associated with abdominopelvic metastases at the time of diagnosis; 32.8% had recurrences, and 19% died of disease. We did not find statistically significant differences in OS and RFS between CCC and GTA at 5 and 10 years (P=0.313 and 0.508, respectively), but there were significant differences in both OS and RFS between CCC and HPVA ECA (P=0.003 and 0.032, respectively). Also, OS and RFS in stage I clear cell and GTA were similar (P=0.632 and 0.692, respectively). Multivariate analysis showed that OS is influenced by the presence of recurrence (P=0.009), while RFS is influenced by the FIGO stage (P=0.025). Cervical CCC has poorer outcomes than HPVA ECA and similar outcomes to human papillomavirus-independent GTA. Oncologic treatment significantly influences RFS in univariate analysis but is not an independent prognostic factor in multivariate analysis suggesting that alternative therapies should be investigated. |
| Keywords: | vagina; clear cell carcinoma; cervix; stage; exposure; update; invasive endocervical adenocarcinoma; cancer; prognosis; gastric type; pattern-based classification |
| Journal Title: | American Journal of Surgical Pathology |
| Volume: | 46 |
| Issue: | 6 |
| ISSN: | 0147-5185 |
| Publisher: | Lippincott Williams & Wilkins |
| Date Published: | 2022-06-01 |
| Start Page: | 765 |
| End Page: | 773 |
| Language: | English |
| ACCESSION: | WOS:000794948700004 |
| DOI: | 10.1097/pas.0000000000001863 |
| PROVIDER: | wos |
| PMCID: | PMC9106829 |
| PUBMED: | 34985047 |
| Notes: | Article -- Source: Wos |
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