Clinicopathological characteristics and prognostic predictors in cervical clear cell adenocarcinoma: A multicenter cohort study.

Abstract

e17505 Background: The clinicopathological profile and prognostic factors of cervical clear cell adenocarcinoma unrelated to diethylstilbestrol exposure are not well characterized in Chinese population. Methods: This multicenter retrospective study was conducted to analyze the characteristics of cervical clear cell adenocarcinoma patients from 10 medical centers. 97 patients surgically diagnosed with primary cervical clear cell adenocarcinoma were collected from 2010 to 2022. A comprehensive clinicopathological profile of cervical clear cell adenocarcinoma patients was depicted. The association between clinicopathological characteristics and prognostic factors was also assessed. Results: The peak age prevalence occurred in the 46-55 years group (n = 97), with the human papillomavirus (HPV)-negative rate of 85.1%. All surgically treated patients had FIGO stages IA-IIA or IIIC and received adjuvant radiotherapy and/or chemotherapy. With a median follow-up of 52 months (interquartile range, 36-70 months), multivariable analysis identified ovarian metastasis (HR = 3.89, P = 0.027 ) and lymph node metastasis (HR = 4.26, P = 0.004 ) as independent risk factors for overall survival. Multivariable analysis also demonstrated that lymph node metastasis (HR = 3.15, P = 0.005 ) remained a significant predictor for progression-free survival. Conclusions: This retrospective multicenter study characterized clinicopathological features of cervical clear cell adenocarcinoma and identified prognostic factors. Univariate and multivariate analysis of factors associated with overall survival. Variables Univariate HR (95%CI) P-value Multivariable HR (95%CI) P-value Tumor size >4 cm 3.85 (1.15–12.91) 0.029 3.13 (0.80–12.24) 0.102 DSI >2/3 8.30 (1.81–38.02) 0.006 3.36 (0.62–18.22) 0.161 Ovarian metastasis (Yes) 3.09 (1.03–9.39) 0.047 3.89 (1.17–12.98) 0.027 LVSI (Yes) 4.47 (1.80–11.07) 0.001 0.49 (0.26–3.58) 0.481 LNM (Yes) 4.80 (1.94–11.86) 0.001 4.26 (1.58–11.45) 0.004 Surgical approach (ARH) 1.57 (0.36–6.79) 0.548 - - HR, hazard ratio; 95%CI, 95% confidence interval; DSI, depth of stromal invasion; LVSI, lymphovascular space invasion; LNM, lymph node metastasis; ARH, abdominal radical hysterectomy; LRH, laparoscopic radical hysterectomy.