Outcome patterns of cervical adenocarcinoma and squamous cell carcinoma following curative surgery: before and after propensity score matching analysis of a cohort study.

To estimate the outcome patterns and predictors of curative surgery for cervical squamous cell carcinoma (SCC) and adenocarcinoma (ADC) for overall survival (OS), locoregional recurrence (LRR), and distant metastasis (DM), we enrolled 4628 patients who had received a diagnosis of cervical SCC or ADC and received curative surgery. Cox regression analysis was employed to calculate hazard ratios and confidence intervals (CIs); independent predictors were controlled for or stratified in the analysis, and the endpoint was all-cause death. Propensity score matching was conducted to create well-balanced groups. Multivariate Cox regression analysis indicated that the pathologic type of ADC, age ≥ 70 years, advanced pathologic stage, positive margin, poorly differentiated cancer, undifferentiated cancer, adjuvant sequential chemotherapy and radiotherapy, earlier year of diagnosis, Charlson comorbidity index (CCI) = 1, CCI ≥ 2, low income levels, and treatment at a nonmedical center were significant independent poor prognostic factors for all-cause mortality in cervical cancer treated with curative surgery. Adjusted hazard ratios (95% CIs) for patients with cervical ADC who received curative surgery were 2.34 (1.96-2.79), 1.15 (0.89-1.49), and 2.16 (1.75-2.66) compared with cervical SCC for all-cause mortality, LRR, and DM, respectively. This study indicated that curative surgery for cervical ADC was associated with poorer OS and higher DM rates relative to cervical SCC, but no significant differences were identified in LRR.