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Does adenocarcinoma have a worse prognosis than squamous cell carcinoma in patients with cervical cancer? A real-world study with a propensity score matching analysis

Journal of Gynecologic Oncology 2020년 31권 6호 p.80 ~ 80
Pan Xingxi, Yang Wen, Wen Zhongyong, Li Feilong, Tong Lihua, Tang Wubing,
소속 상세정보
 ( Pan Xingxi ) - Southern Medical University Second School of Clinical Medicine Nanhai People’s Hospital Department of Oncology
 ( Yang Wen ) - Southern Medical University Second School of Clinical Medicine Nanhai People’s Hospital Department of Oncology
 ( Wen Zhongyong ) - Southern Medical University Second School of Clinical Medicine Nanhai People’s Hospital Department of Gynecology
 ( Li Feilong ) - Southern Medical University Second School of Clinical Medicine Nanhai People’s Hospital Department of Oncology
 ( Tong Lihua ) - Southern Medical University Second School of Clinical Medicine Nanhai People’s Hospital Department of Oncology
 ( Tang Wubing ) - Southern Medical University Second School of Clinical Medicine Nanhai People’s Hospital Department of Oncology

Abstract


Objective: To compare survival outcomes between cervical adenocarcinoma (ADC) and squamous cell carcinoma (SCC) using a propensity score matching (PSM) analysis based on the Surveillance, Epidemiology, and End Results (SEER) Program.

Methods: Patients diagnosed with cervical cancer between 1998 and 2016 were identified from the SEER database. The Kaplan-Meier method and Cox regression analysis were used to analyze survival. A subgroup analysis of overall survival (OS) between patients with ADC and SCC was performed after the 1:1 PSM analysis.

Results: Of the 33,148 patients, 24,591 (79.19%) had SCC and 8,557 (25.81%) had ADC. In the unmatched cohort, after adjustment in multivariate analysis, patients with ADC had a worse prognosis than patients with SCC (hazard ratio [HR]=1.12; 95% confidence interval [CI]=1.07?1.18; p<0.001). In the propensity matched cohort, Kaplan-Meier analysis and subgroup analysis showed that ADC was associated with a worse prognosis than SCC (p=0.001). An analysis stratified by SEER stage revealed a worse prognosis for patients with ADC patients presenting with a regional disease than patients with SCC (HR=1.24; 95% CI=1.14?1.36 p<0.001), but no statistically significant differences were observed between the localized disease (HR=0.97; 95% CI=0.86?1.10; p=0.664) and distant disease (HR=1.09; 95% CI=0.97?1.22; p=0.162) subgroups.

Conclusion: The significant differences in survival outcomes between patients with cervical ADC and SCC were only observed in the regional disease subgroup, but not in the localized disease and distant disease subgroups.

키워드

Cervical Cancer; Adenocarcinoma; Squamous Cell Carcinoma; Propensity Score; Survival

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