Question: In a 37 year old fit and otherwise healthy woman, what is the prognosis for
- Primary adenoma malignum of the cervix
- Recurrence of adenoma malignum of the cervix
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Answer: A review article published in 2002 (1) has the following information about prognosis:
“Reports of the prognosis for patients with adenoma malignum have not provided uniform data. Several investigators reported a poor prognosis (20,23,37), whereas some found a relatively favorable prognosis similar to that for other well-differentiated cervical adenocarcinomas (21,22). In the study by Gilks and associates (23) in which their cases were combined with others in the literature, only about 30% of 57 patients were alive and free of disease at 2 years, whereas 50% of patients with Stage I tumors and 60% of patients with Stage II disease died of recurrent tumor, despite radical therapy in most cases. In the study mentioned earlier in which the tumors were initially diagnosed by Pap smear, the 5-year survival rate of six patients (five Stage I, one Stage II) was 100% with one patient dying of disease shortly thereafter.”
(Evidence level III)
Reference:
- Symposium part II: special types of adenocarcinoma of the uterine cervix. Hart WR. International Journal of Gynecological Pathology. 21(4):327-46, 2002 Oct. Full text available to Fellows, Members and Trainees
Search date: June 2009
Classification of evidence levels
Ia Evidence obtained from meta-analysis of randomised controlled trials.
Ib Evidence obtained from at least one randomised controlled trial.
IIa Evidence obtained from at least one well-designed controlled study without randomisation.
IIb Evidence obtained from at least one other type of well-designed quasi-experimental study.
III Evidence obtained from well-designed non-experimental descriptive studies, such as comparative studies, correlation studies and case studies.
IV Evidence obtained from expert committee reports or opinions and/or clinical experience of respected authorities.
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