Background There has been limited research on the comparison of squamous cell carcinoma (SCC) and adenocarcinoma (AC) of cervical cancer and that lack of information may have significant bearing on the treatment of patients. We compared survival outcomes between squamous cell carcinoma and adenocarcinoma in locally advanced cervical cancer patients and examined factors related to the prognosis of cervical cancer. Methods We identified 4131 patients with stage IB2-IVA cervical cancer patients diagnosed between 2010 and 2015 by using the Surveillance, Epidemiology, and End Results (SEER) database. Variables related to the prognosis of cervical cancer were compared using both univariate and multivariate Cox models and log-rank method before and after propensity score matching. We compared the efficacy of radiotherapy alone to radiotherapy combined with chemotherapy or/and surgery in overall survival of SCC and AC. Results Our sample included 3385 patients with SCC (81.9%) and 746 patients with AC (18.1%). The 5-year overall survival on comparing the squamous cell carcinoma group and adenocarcinoma group was not significant ( P > 0.05). Using propensity score matching, 676 pairs of patients were selected. The 5-year overall survival of matched patients did not differ significantly ( P > 0.05). Histology was not independently associated with overall survival in multivariate Cox model (P > 0.05). Factors affecting overall survival included FIGO stage IVA ( P < 0.05), chemotherapy (P < 0.05), and external radiation combined with brachytherapy (P < 0.05). Patients with SCC that were treated with radiation alone had significantly worse OS than AC patients receiving radiation only ( P < 0.05). Conclusions The OS in AC of the cervix is similar to that SCC in when treated with radiotherapy combined with chemotherapy and/or surgery but better when treated with radiation alone.

中文翻译：

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在监测、流行病学和最终结果 (SEER) 数据库中按组织病理学类型比较局部晚期宫颈癌的生存结果：倾向评分匹配研究

背景关于宫颈癌鳞状细胞癌（SCC）和腺癌（AC）的比较研究有限，缺乏信息可能对患者的治疗产生重大影响。我们比较了局部晚期宫颈癌患者鳞状细胞癌和腺癌的生存结果，并检查了与宫颈癌预后相关的因素。方法 我们使用监测、流行病学和最终结果 (SEER) 数据库确定了 2010 年至 2015 年间诊断的 4131 名 IB2-IVA 期宫颈癌患者。采用单变量和多变量 Cox 模型和对数秩法在倾向评分匹配前后比较与宫颈癌预后相关的变量。我们比较了单独放疗与放疗联合化疗或/和手术对 SCC 和 AC 总生存期的疗效。结果 我们的样本包括 3385 名 SCC 患者（81.9%）和 746 名 AC 患者（18.1%）。鳞癌组与腺癌组5年总生存率比较，差异无统计学意义（P>0.05）。使用倾向评分匹配，选择了 676 对患者。匹配患者的5年总生存率差异无统计学意义（ P > 0.05）。在多变量 Cox 模型中，组织学与总生存率不独立相关（P > 0.05）。影响总生存期的因素包括FIGO IVA期（P < 0.05）、化疗（P < 0.05）、外照射联合近距离放疗（P < 0.05）。单独接受放射治疗的 SCC 患者的 OS 显着低于单独接受放射治疗的 AC 患者（ P < 0.05）。结论 放疗联合化疗和/或手术治疗宫颈 AC 的 OS 与 SCC 相似，但单独放疗的 OS 更好。