Prognostic factors in adenocarcinoma of the uterine cervix

A group of 136 female patients with adenocarcinoma of the uterine cervix, treated at Memorial Sloan-Kettering Cancer Center between 1949 and 1981, with slides available for review, formed the basis for this study. They ranged in age from 10 to 91 years. Most (73%) had abnormal bleeding, either alone or in combination with other symptoms; 15% were asymptomatic. Eighty percent had a visible abnormality, most commonly an exophytic mass. Clinical stages were: 0 (3%), IB (61%), IIA (14%), IIB (10%), III (4%). There were four major histologic subtypes: mucinous (47%), endometrioid (24%), adenosquamous (15%), and clear cell (9%) carcinoma. Of the many clinicopathologic variables evaluated for prognosis, the most significant was stage of disease (P less than 0.0001). Those with Stage IB disease had a survival probability of 76% at 5 years compared with 49% for those with Stage IIA and 34% with Stage IIB. The endometrioid pattern was associated with a more favorable prognosis than any other histologic subtype (P = 0.02). The presence of lymphatic tumor emboli and/or metastatic carcinoma in any lymph node group was associated with a less favorable prognosis for patients with Stage IB and IIA disease (P less than 0.0001).