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Prognostic impact of primary surgery in human papillomavirus-independent, advanced or metastatic endocervical adenocarcinoma: A bi-institutional retrospective study

  • 0Gynecologic Cancer Center, Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
International Journal of Gynaecology and Obstetrics : the Official Organ of the International Federation of Gynaecology and Obstetrics +

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February 18, 2025

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February 18, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

Primary surgery significantly improves survival for advanced HPV-independent endocervical adenocarcinoma (EAC). Patients undergoing surgery experienced longer progression-free and overall survival compared to those receiving non-surgical treatments.

Area Of Science

  • Gynecologic Oncology
  • Surgical Oncology
  • Cancer Research

Background

  • HPV-independent advanced or metastatic endocervical adenocarcinoma (EAC) presents poor prognosis and resistance to conventional therapies.
  • Standard treatments like chemoradiotherapy often yield limited success in this aggressive subtype.

Purpose Of The Study

  • To assess the prognostic value of primary surgery in patients with HPV-independent advanced or metastatic EAC.
  • To compare survival outcomes between patients treated with primary surgery versus non-surgical approaches.

Main Methods

  • A retrospective bi-institutional study included 92 patients with HPV-independent advanced/metastatic EAC (2001-2023).
  • Patients were categorized into primary surgery (n=54) or non-surgical treatment (n=38) groups.
  • Kaplan-Meier and multivariate analyses evaluated progression-free survival (PFS) and overall survival (OS).

Main Results

  • The surgery group showed significantly better PFS (19.2 vs. 10.0 months, P<0.001) and OS (not reached vs. 24.1 months, P=0.002).
  • Non-surgical treatment was an independent predictor of poor PFS (HR 2.25) and OS (HR 3.25).
  • Recurrence rates were lower in the surgery group (55.6% vs. 84.2%, P=0.006).

Conclusions

  • Primary surgery offers a significant survival benefit for patients with HPV-independent advanced or metastatic EAC.
  • Surgery should be integrated into multimodal treatment strategies for this aggressive cancer.
  • Individualized therapeutic approaches are crucial, moving beyond standard chemoradiotherapy protocols.

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