Minimal deviation adenocarcinoma (adenoma malignum) of the uterine cervix: clinicopathological analysis of 17 cases.
10.5468/ogs.2018.61.5.590
- Author:
Min Hee LEE
1
;
Eun Soo KIM
;
Min Chul CHOI
;
Jin Hyung HEO
;
Ja Hyun JANG
;
Sang Geun JUNG
;
Hyun PARK
;
Won Duk JOO
;
Chan LEE
;
Je Ho LEE
Author Information
1. Comprehensive Gynecologic Cancer Center, Department of Obstetrics and Gynecology, CHA Bundang Medical Center, CHA University, Seongnam, Korea. chanoncology@chamc.co.kr, oursk79@cha.ac.kr
- Publication Type:Original Article
- Keywords:
Cervical cancer;
Minimal deviation adenocarcinoma;
Peutz-Jeghers syndrome;
Prognostic factors
- MeSH:
Adenocarcinoma*;
Cervix Uteri*;
Diagnosis, Differential;
Early Diagnosis;
Female;
Follow-Up Studies;
Genetic Testing;
Humans;
Hysterectomy;
Mass Screening;
Medical Records;
Multivariate Analysis;
Peutz-Jeghers Syndrome;
Retrospective Studies;
Uterine Cervical Neoplasms
- From:Obstetrics & Gynecology Science
2018;61(5):590-597
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: The aim of this study was to evaluate the clinicopathological features of minimal deviation adenocarcinoma (MDA) and to analyze its prognostic factors. METHODS: We retrospectively analyzed the medical records of 17 patients who were diagnosed with MDA at a single institution between January 2005 and December 2015. RESULTS: The median age of the patients was 47.7 years (33–75 years). MDA was diagnosed in 7 patients (41.2%) before performing definitive surgery. Stage IB disease was diagnosed in 12 patients (70.6%) and advanced stage disease (stage II: 3, stage III: 2) in 5. MDA was incidentally diagnosed following hysterectomy for benign conditions in 6 patients. Adjuvant therapy was administered to 13 patients (76.5%). During median follow-up over 33.6 months (7–99 months), 11 patients (64.7%) showed no evidence of disease, 6 (35.3%) showed persistent or recurrent disease and 5 died of the disease. Peutz-Jeghers syndrome was not suspected in any patient, and no mutation was detected in the 3 patients who underwent genetic testing. Univariate analysis showed that advanced stage disease (P=0.016) and lymphovascular space invasion (P=0.002) demonstrated a statistically significant association with poor overall survival (OS) rates. Advanced stage disease continued to show a significant association with poor OS rates (hazard ratio, 2.92; 95% confidence interval, 1.097–7.746; P=0.032) even after multivariate analysis. CONCLUSION: Early diagnosis is important to manage MDA. Clinicians should consider MDA among the differential diagnoses in patients with a suspicious clinical presentation even with negative cervical screening tests.
