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KMID : 1143220180610050590
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Obstetrics & Gynecology Science
2018 Volume.61 No. 5 p.590 ~ p.597
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Minimal deviation adenocarcinoma (adenoma malignum) of the uterine cervix: clinicopathological analysis of 17 cases
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Lee Min-Hee
Kim Eun-Soo
Choi Min-Chul
Heo Jin-Hyung
Jang Ja-Hyun
Jung Sang-Geun
Park Hyun
Joo Won-Duk
Lee Chan
Lee Je-Ho
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Abstract
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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.
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KEYWORD
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Cervical cancer, Minimal deviation adenocarcinoma, Peutz-Jeghers syndrome, Prognostic factors
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