Proposal of a two-tier system in grouping adenocarcinoma of the uterine cervix

Hiroko Machida, Koji Matsuo, Shinya Matsuzaki, Wataru Yamagami, Yasuhiko Ebina, Yoichi Kobayashi, Tsutomu Tabata, Masanori Kaneuchi, Satoru Nagase, Takayuki Enomoto, Mikio Mikami

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)


(1) Background: This study examined the use of a two-tier system in grouping cervical adenocarcinoma for survival discrimination. (2) Methods: A nationwide retrospective observational cohort study was conducted using the Japan Society of Gynecologic Oncology tumor registry database from 2001 to 2015 (n = 86,754). Adenocarcinoma subtypes were grouped as type 1 (endocervical usual type and endometrioid) or type 2 (serous, clear, mucinous, and not otherwise specified), based on their relative survival compared with that of squamous tumors. (3) Results: The majority of the adenocarcinoma cases were type 1 (n = 10,121) versus type 2 tumors (n = 5157). Type 2 tumors were more likely to be old and have stage IV disease than those with squamous tumors. The number of type 2 tumors increased from 2001 to 2014 (106.1% relative increase, p < 0.001). Type 2 tumors had disproportionally poorer survival compared to other types (5-year survival rates: 68.9% for type 2, 75.4% for type 1, and 78.0% for squamous; p < 0.001). On multivariate analysis, type 2 tumors remained an independent prognostic factor associated with decreased survival compared with squamous (adjusted hazard ratio 2.00, 95% CI 1.84–2.15, p < 0.001). (4) Conclusion: The survival of cervical adenocarcinoma varies largely across the histological subtypes, and the proposed two-tier grouping may be useful for survival discrimination.

Original languageEnglish
Article number1251
Issue number5
Publication statusPublished - 2020 May


  • Adenocarcinoma
  • Cervical cancer
  • Histological subtypes
  • Survival

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


Dive into the research topics of 'Proposal of a two-tier system in grouping adenocarcinoma of the uterine cervix'. Together they form a unique fingerprint.

Cite this