Janmejaya Mohapatra 1 , Jita Parija 2
BACKGROUND Adenocarcinoma comprises of about 10% of cancer cervix. Late presentation, infiltrative growth, larger tumour bulk, poor radiosensitivity and quick recurrence makes this disease a field of special concern. Very low number of cases are reported in literature. Therefore, a standard protocol for management of adenocarcinoma has not yet been clearly established. This study is an observational study from the pool of total number of early invasive cancer cervix who had undergone radical surgery in our institute and compare them with squamous cell carcinomas of cervix with regard to several parameters like incidence, age, parity, histopathology, morphology, response to treatment and recurrence patterns. MATERIALS AND METHODS A total number of 541 patients of early invasive cancer cervix who underwent radical hysterectomy during the period January 2006 to January 2016 in A.H. Regional Cancer Centre, Cuttack, and followed upto 5 years or more were studied. A retrospective analysis was done to study the incidence and observe and compare the epidemiological parameters, histopathological grade, morphology, nodal involvement and survival statistics of adenocarcinoma with that of squamous cell carcinoma of cervix. RESULTS Adenocarcinoma comprised 9.1% of total number of cases. Majority were 50-59 years and in para 3-4 group. Infiltrative lesion was seen in 44% of cases, 40% of the growth were more than 5 cm in diameter and 92% were well-differentiated. Though nodal involvement didn’t show much difference from squamous cell cancer, 36% of adenocarcinomas needed adjuvant radiotherapy. The 5 years disease-free survival was better with squamous carcinoma (88.4%) than adenocarcinoma (84%). CONCLUSION Though, potentially a different tumour compared to squamous cell carcinoma, for adenocarcinomas of cervix surgery is the mainstay of treatment. The role of radiotherapy, being controversial, judicious postoperative radiotherapy has to be given as and when required.
