Stage IIB–IVB Cervical Adenocarcinoma: Prognostic Factors and Survival Jayanthi S. Lea, M.D.,* Ellen E. Sheets, M.D.,² Robert M. Wenham, M.D.,² Linda R. Duska, M.D.,‡ Robert L. Coleman, M.D.,* David S. Miller, M.D.,* and John O. Schorge, M.D.* ,1 *University of Texas Southwestern Medical Center, Dallas, Texas 75390-9032; ² Brigham and Women’s Hospital, Boston, Massachusetts 02115; and ‡Massachusetts General Hospital, Boston, Massachusetts 02114 Received July 3, 2001 Objective. The incidence of cervical adenocarcinoma is increas- ing relative to squamous cell carcinoma and all cervical cancers. Few reports have described the outcome of patients with advanced cervical adenocarcinoma. The purpose of this study was to deter- mine the prognostic factors and survival for patients with stage IIB–IVB disease. Methods. Institutional Review Board approval was obtained to perform a computerized search of all women diagnosed with cervical adenocarcinoma at our three institutions between 1982 and 2000. Medical records were retrospectively reviewed. Clinical follow-up was obtained from the SGO database and tumor registry and via correspondence with health care providers. Statistical analysis was performed using logistic regression forclinical vari- ables and the log-rank test to compare Kaplan–Meier survival estimates. Results. Eighty-three women with FIGO stage IIB–IVB cervical adenocarcinoma were identified. The median patient age was 53 years (range, 22–88). The median follow-up of 17 (20%) surviving patients was 33 months (range, 6–147); 66 (80%) died during the study interval. Stage IIB disease, young patient age, and grade 1 histology were independent variables having a favorable impact on survival (each P < 0.02). Stage IIB patients (n  41) were more likely to be alive at 2 (64%vs 8%) and 5 years (30%vs 0%) than women with stage IIIA–IVB disease (n  42; P < 0.01). Conclusions. Women diagnosed with advanced stage cervical adenocarcinoma have a poor prognosis. Prospective, multicenter trials of platinum-based chemoradiation or other novel therapies are urgently needed in the treatment of this highly lethal disease. © 2002 Elsevier Science INTRODUCTION The incidence of cervical adenocarcinoma has increased over the past few decades, while the incidence of all cervical cancer and squamous cell carcinoma has continued to decline. The proportion of adenocarcinoma has increased 107% relative to all cervical cancer, 95% relative to squamous cell carci- noma, and 49% relative to the population of women at risk [1]. Adenocarcinoma of the uterine cervix currently accounts for 16 –24% of all cervical carcinomas [1, 2]. Retrospective analyses suggest that advanced cervical ade- nocarcinomas are sensitive to platinum-based chemotherapy [3, 4]. Recent prospective, randomized studies from the Gyne- cologic Oncology Group indicate that patients with locally advanced cervical cancer who receive primary platinum-based chemoradiation have a significant improvement in clinical out- come [5–7]. However, the majority of the patients included in these reports have squamous cell histology; adenocarcinomas represent approximately 10% of the patients enrolled [5, 6]. Few reports have described the outcome of patients with advanced cervical adenocarcinoma [8 –13]. These lesions are thought to have a poorer prognosis than squamous carcinomas because they are more difficult to detect, are believed to be more radioresistant, and may metastasize earlier in their course [14, 15]. The purpose of this study was to determine the prognostic factors and survival for patients with stage IIB–IVB cervical adenocarcinoma. MATERIALS AND METHODS Institutional Review Board approvals were obtained at the University of Texas Southwestern Medical Center, Brigham and Women’s Hospital, and Massachusetts General Hospital. A computerized search was performed to detect all women diagnosed with cervical adenocarcinoma from January 1982 to July 2000. Medical records were retrospectively reviewed to obtain patient demographics, surgical–pathologic data, and clinical outcome. Women were clinically staged using the International Federation of Gynecology and Obstetrics (FIGO) staging system for cervix cancer [16]. Clinical follow-up was obtained from the SGO database, tumor registry, and institu- tional records and via correspondence with health care provid- ers. Treatment was based on FIGO clinical stage and the extent 1 To whom correspondence and reprint requests should be addressed at Division of Gynecologic Oncology, UT Southwestern Medical Center, 5323 Harry Hines Blvd., J7.124, Dallas, TX 75390-9032. Fax: 214-648-8404. E-mail: john.schorge@utsouthwestern.edu. Gynecologic Oncology 84, 115–119 (2002) doi:10.1006/gyno.2001.6473, available online at http://www.idealibrary.com on 115 0090-8258/02 $35.00 © 2002 Elsevier Science All rights reserved.