Early adenocarcinoma of the uterine cervix

The purpose of this study was to evaluate the prognostic significance of the tumor depth, horizontal spread, and volume in early cervical adenocarcinoma while excluding adenocarcinoma in situ. Thirty cases who had been treated at our institution having cervical adenocarcinoma with a tumor depth of less than 5 mm were clinicopathologically reviewed. The volumes were estimated based on the portion with the largest tumor surface area by multiplying three dimensions: depth, horizontal spread, and a third dimension. The third dimension was calculated by the method of Burghardt to be 1.5 times the largest measured depth or spread. Two of the 30 patients recurred in the vagina at 18 and 163 months after the initial operation; the former patient died of disease 87 months postoperatively. The remaining 28 patients are all doing well without recurrence (range of follow-up from 24 to 232 months; median 79 months). No pelvic or paraaortic lymph node metastases were seen in 25 and 22 cases, respectively. None of the 21 cases with a lesion measuring less than 3 mm in depth had recurrence. On the other hand, 1 of 23 with a tumor volume up to 500 mm3 had recurrence. The estimated 5-year progression-free survival rates for patients with cervical adenocarcinoma with a depth of less than 3 mm and those with a depth of more than 3 mm were 100 and 88.89%, respectively (P = 0.116). The depth of stromal invasion may therefore be a good predictor of lymph node metastasis and recurrence in early cervical adenocarcinoma.