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

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

Authors:	Ehmann, S.; Sassine, D.; Straubhar, A. M.; Praiss, A. M.; Aghajanian, C.; Alektiar, K. M.; Broach, V.; Cadoo, K. A.; Jewell, E. L.; Boroujeni, A. M.; Kyi, C.; Leitao, M. M.; Mueller, J. J.; Murali, R.; Bhaloo, S. I.; O'Cearbhaill, R. E.; Park, K. J.; Sonoda, Y.; Weigelt, B.; Zamarin, D.; Abu-Rustum, N.; Friedman, C. F.
Article Title:	Gastric-type adenocarcinoma of the cervix: Clinical outcomes and genomic drivers
Abstract:	OBJECTIVES: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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. Copyright © 2022 Elsevier Inc. All rights reserved.
Keywords:	retrospective studies; cancer staging; neoplasm staging; adenocarcinoma; retrospective study; uterine cervical neoplasms; stomach neoplasms; uterine cervix tumor; chemoradiotherapy; stomach tumor; cervical cancer; papillomavirus infections; papillomavirus infection; adenoma malignum; humans; human; female; gastric-type endocervical adenocarcinoma; genetic profile; endocervical cancer
Journal Title:	Gynecologic Oncology
Volume:	167
Issue:	3
ISSN:	0090-8258
Publisher:	Elsevier Inc.
Date Published:	2022-12-01
Start Page:	458
End Page:	466
Language:	English
DOI:	10.1016/j.ygyno.2022.10.003
PUBMED:	36253302
PROVIDER:	scopus
PMCID:	PMC10155605
DOI/URL:	https://www.scopus.com/inward/record.uri?eid=2-s2.0-85143916864&doi=10.1016%2fj.ygyno.2022.10.003&partnerID=40&md5=f100ec7483cd7e13c8a52e2c256855e1
Notes:	Article -- Export Date: 3 January 2023 -- Source: Scopus