OBJECTIVE
Glassy cell carcinoma (GCC) of the cervix has traditionally been characterized as an aggressive histologic subtype with poor outcomes. An earlier series from our institution supported a grim prognostic outlook, demonstrating a survival rate of only 55% in women with stage I disease. We present a comparison of a contemporary series of patients with GCC.
METHODS
All cases of GCC treated from 1993 to 1999 identified by our tumor registry were reviewed for a variety of clinicopathologic features, treatment strategies, and outcome.
RESULTS
A total of 403 cases of invasive cancer of the cervix were identified. There were 22 patients with histologically confirmed GCC, representing only 5.4% of all cervical cancer diagnoses. Patients with GCC had an overall survival of 73% (16/22) and a disease-free survival of 64% (14/22). The incidence of stage I lesions was 64% (14/22). Overall survival of patients with stage I disease was 86% (12/14), with a disease-free survival of 71% (10/14) at a median follow-up of 28.5 months. Seven stage IB lesions were treated with surgery alone, whereas six received adjuvant radiation or chemoradiation following surgery. Two patients in each treatment group recurred, yielding an overall recurrence rate of 29% (4/14). However, of those who recurred with stage I disease, all 4 patients had two or more intermediate risk factors (lymph-vascular space invasion [LVSI], deep tumor invasion, or tumor size greater than 3 cm).
CONCLUSIONS
Glassy cell carcinoma of the cervix appears to have a better prognosis than previously reported. We observed that intermediate risk histopathologic features identified in squamous cell cohorts are also predictive of a poorer outcome in patients with GCC. Thus, patients with LVSI, deep stromal invasion, and large tumor size are at the highest risk for pelvic relapse and should be candidates for adjuvant treatment.
[1]
W. Koh,et al.
Adjuvant therapy for high-risk, early stage cervical cancer.
,
2000,
Seminars in radiation oncology.
[2]
B N Bundy,et al.
A randomized trial of pelvic radiation therapy versus no further therapy in selected patients with stage IB carcinoma of the cervix after radical hysterectomy and pelvic lymphadenectomy: A Gynecologic Oncology Group Study.
,
1999,
Gynecologic oncology.
[3]
M. Heywood,et al.
Glassy cell carcinoma of the cervix: a bimodal treatment strategy.
,
1992,
Gynecologic oncology.
[4]
J. Cain,et al.
Glassy Cell Carcinoma of the Cervix Redefined
,
1988,
Obstetrics and gynecology.
[5]
H. Pak,et al.
Glassy cell carcinoma of the cervix cytologic and clinicopathologic analysis
,
1983,
Cancer.
[6]
R. C. Maier,et al.
Glassy Cell Carcinoma of the Cervix
,
1982,
Obstetrics and gynecology.
[7]
R. Zaino,et al.
Glassy cell carcinoma of the uterine cervix. An ultrastructural study and review.
,
1982,
Archives of pathology & laboratory medicine.
[8]
A. Sedlis,et al.
Glassy cell cervical carcinoma.
,
1979,
Gynecologic oncology.
[9]
Stanley,et al.
Glassy cell carcinoma of the cervix
,
1976,
Cancer.
[10]
A. Glücksmann,et al.
Incidence, histology, and response to radiation of mixed carcinomas (adenoacanthomas) of the uterine cervix
,
1956,
Cancer.