Primary adenocarcinoma of the cervix. A clinicopathologic study of prognostic variables in 55 cases

Fifty-five primary invasive adenocarcinomas of the cervix, presenting over a 20-year period, were retrospectively studied with particular reference to clinical and pathologic prognostic indicators. Mean age at presentation was 54.5 years (range 27-91), with an age distribution showing two incidence peaks of equal size in the 31-35 and 61-65 groups, respectively. Twenty-four patients died of the disease and the remaining patients were followed up for a mean of 4.9 years (range 1-17). The results were analyzed using a Cox's proportional hazards survival model. The independent good prognostic indicators were early tumor stage (P < 0.001). and young patient age (P < 0.001) at presentation. The presence within the tumor of numerous intraepithelial lymphocytes and the concomitant occurrence of background in situ carcinoma were also good prognostic indicators, although these did not operate independently of stage and age. Histologic tumor subtype and grade of tumor differentiation were not significant prognostic factors. Treatment did not have a significant independent effect on survival. No definite conclusions could be drawn about the effect of oral contraceptives on the disease process.