Glassy cell carcinoma of the cervix: a systematic review and meta-analysis

Gynecol Oncol. 2014 May;133(2):186-91. doi: 10.1016/j.ygyno.2014.01.048. Epub 2014 Feb 4.

Abstract

Objective: The purpose of this study is to summarize the data on the incidence, clinical behavior and overall survival of patients with glassy cell cervical carcinoma (GCCC).

Methods: Twenty-four case series and fifteen case reports identified by searching PubMed database qualified for inclusion in this study. The published cases were combined with data from a retrospective chart review of patients with GCCC in two major teaching hospitals in Brooklyn, NY.

Results: A total of 292 cases were collected through our literature and chart review. Median age at diagnosis was 45 years old (range 12-87 years of age). GCCC incidence ranges from 0.2 to 9.3% of all cervical cancers and 2 to 30.2% of cervical adenocarcinomas. The stage distribution is similar to squamous cell carcinoma with 79% of the patients being diagnosed with Stage I or II disease. Most common sites of recurrence for Stage I patients are the vagina and pelvis. In Stage II patients locoregional and distant metastases are equally common. Recurrence rate was higher among patients treated only with surgery (32.7%), as compared to patients treated with surgery followed by radiation (11%) or patients treated with radiation only (10%). Median overall survival (OS) was 25 months (95% CI 8.4-41.6). Overall 5-year survival for all stages is lower when compared to all cervical cancers (54.8% vs 75%). There was no interaction between race and OS (p=0.66).

Conclusion: GCCC is a rare histologic type of cervical cancer that presents at a younger age, is associated with high risk for distant failure and carries worse prognosis as compared to the squamous cell type. Radiation therapy is associated with decreased risk of recurrence.

Keywords: Cervix; Glassy cell carcinoma; Metaanalysis.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents / therapeutic use*
  • Carcinoma, Adenosquamous / mortality
  • Carcinoma, Adenosquamous / pathology
  • Carcinoma, Adenosquamous / therapy*
  • Child
  • Combined Modality Therapy / methods
  • Female
  • Humans
  • Hysterectomy
  • Middle Aged
  • Neoplasm Recurrence, Local*
  • Neoplasm Staging
  • Prognosis
  • Radiotherapy
  • Retrospective Studies
  • Uterine Cervical Neoplasms / mortality
  • Uterine Cervical Neoplasms / pathology
  • Uterine Cervical Neoplasms / secondary
  • Uterine Cervical Neoplasms / therapy*
  • Young Adult

Substances

  • Antineoplastic Agents

Supplementary concepts

  • Glassy cell carcinoma of the cervix