Isabel Alvarado-Cabrero, MD, PhD,* W. Glenn McCluggage, FRCPath,†
Rafael Estevez-Castro, MD,‡ Delia Pérez-Montiel, MD,§ Simona Stolnicu, MD, PhD,∥ Raji Ganesan, MD,¶ Josefa Vella, MBCh, MSc, FRCPath,¶ Rosario Castro, MD,#
Javier Canedo-Matute, MD,** Jessica Gomez-Cifuentes, MD,†† Vilma M. Rivas-Lemus, MD,‡‡
Kay J. Park, MD,§§ Robert A. Soslow, MD,§§ Esther Oliva, MD,∥∥ and Raquel Valencia-Cedillo, MD
Abstract: Micropapillary adenocarcinoma has been reported as an aggressive variant of adenocarcinoma in several organs, where it is associated with poor clinical outcome. This study reports the clin- icopathologic features and outcomes of cervical adenocarcinomas with a micropapillary component (micropapillary cervical ad- enocarcinomas); this represents the largest reported study of these neoplasms. The study comprised 44 cervical adenocarcinomas of usual (human papillomavirus–related)-type (84%), mucinous, not otherwise specified (4.5%), gastric-type (4.5%), endometrioid (4.5%), and adenosquamous carcinoma (2%). The micropapillary compo- nent comprised > 50% of the neoplasm in 34 cases (77%) (group 1), and 10% to 50% in 10 cases (23%) (group 2). Lymph node meta- stasis was present in 41 of 44 (93%) cases and typically the nodal tumor retained a prominent micropapillary morphology. Follow-up ranged from 7 to 123 months (mean, 65.9 mo). Seventeen of 44 (38.6%) patients had no evidence of disease on follow-up, 6/44 (13.6%) were alive with disease, and 21/44 (47.7%) died of disease. There were no survival differences between group 1 and group 2. On univariate analysis, lymph node metastasis (P = 0.0015), lympho- vascular space invasion (P = 0.002), parametrial involvement (P = 0.03), and depth of stromal invasion (P = 0.045) were related to tumor recurrence. On multivariate analysis, lymph node metastasis.