Gastric-type endocervical adenocarcinoma an aggressive tumor with unusual metastatic patterns and poor prognosis Journal Article
| Authors: | Karamurzin, Y. S.; Kiyokawa, T.; Parkash, V.; Jotwani, A. R.; Patel, P.; Pike, M. C.; Soslow, R. A.; Park, K. J. |
| Article Title: | Gastric-type endocervical adenocarcinoma an aggressive tumor with unusual metastatic patterns and poor prognosis |
| Abstract: | Gastric-type adenocarcinoma of the uterine cervix (GAS) is a rare variant of mucinous endocervical adenocarcinoma not etiologically associated with human papillomavirus (HPV) infection, with minimal deviation adenocarcinoma (MDA) at the well-differentiated end of the morphologic spectrum. These tumors are reported to have worse prognosis than usual HPV associated endocervical adenocarcinoma (UEA). A retrospective review of GAS was performed from the pathology databases of 3 institutions spanning 20 years. Stage, metastatic patterns, and overall survival were documented. Forty GAS cases were identified, with clinical follow-up data available for 38. The tumors were subclassified as MDA (n=13) and non- MDA GAS (n=27). Two patients were syndromic (1 Li- Fraumeni, 1 Peutz-Jeghers). At presentation, 59% were advanced stage (FIGO II to IV), 50% had lymph node metastases, 35% had ovarian involvement, 20% had abdominal disease, 39% had at least 1 site of metastasis at the time of initial surgery, and 12% of patients experienced distant recurrence. The metastatic sites included lymph nodes, adnexa, omentum, bowel, peritoneum, diaphragm, abdominal wall, bladder, vagina, appendix, and brain. Follow-up ranged from 1.4 to 136.0 months (mean, 33.9 mo); 20/38 (52.6%) had no evidence of disease, 3/38 (7.9%) were alive with disease, and 15/38 (39.5%) died of disease. Disease-specific survival at 5 years was 42% for GAS versus 91% for UEA. There were no survival differences between MDA and non-MDA GAS. GAS represents a distinct, biologically aggressive type of endocervical adenocarcinoma. The majority of patients present at advanced stage and pelvic, abdominal, and distant metastases are not uncommon. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved. |
| Keywords: | adenocarcinoma; metastasis; carcinoma; cervix; gastric; hpv; minimal deviation; clinical outcomes; lobular endocervical glandular hyperplasia |
| Journal Title: | American Journal of Surgical Pathology |
| Volume: | 39 |
| Issue: | 11 |
| ISSN: | 0147-5185 |
| Publisher: | Lippincott Williams & Wilkins |
| Date Published: | 2015-11-01 |
| Start Page: | 1449 |
| End Page: | 1457 |
| Language: | English |
| PROVIDER: | scopus |
| PUBMED: | 26457350 |
| DOI: | 10.1097/PAS.0000000000000532 |
| PMCID: | PMC4976691 |
| DOI/URL: | |
| Notes: | Export Date: 2 November 2015 -- Source: Scopus |
Altmetric
Citation Impact
BMJ Impact Analytics
Related MSK Work