Gastric-type adenocarcinoma of the uterine cervix from 2013 to 2023: Clinical characteristics and outcomes

Purpose To summarise our experience with gastric-type adenocarcinoma of the uterine cervix (GAS) at multiple cancer centres. Methods This retrospective study included patients diagnosed with GAS (from 1 June 2013 to 1 July 2023) from three collaborating institutions. Kaplan–Meier survival analysis was used to determine progression-free survival (PFS) and overall survival (OS). Results Among the 116 patients with GAS, 71 had negative human papillomavirus (HPV) genotyping results: ThinPrep cytologic test negative for intraepithelial lesion or malignancy in 45; atypical squamous cells of undetermined significance in 8; atypical squamous cells, which cannot exclude a high-grade squamous intraepithelial lesion, in 2; low-grade squamous intraepithelial lesion in 2; high-grade squamous intraepithelial lesion in 5; atypical glandular cell in 19; and adenocarcinoma in 3 patients. Most patients with GAS had advanced stage disease, with only 32.8% having stage I disease. The International Federation of Gynecology and Obstetrics stages were IB, II, III, and IV in 38, 11, 40, and 18 patients, respectively. The median PFS times for stage I and II–IV diseases were 74.9 and 61.3 months, respectively. The median OS times for patients with stage I and II–IV GAS were 109.7 and 87.6 months, respectively. The median PFS times were 74.9, 75.7, 60.3, and 12.8 months for stages I, II, III, and IV, respectively. Conclusion GAS is an aggressive form of cervical cancer with poor PFS and OS when diagnosed at stage II or higher.