Clear cell carcinoma of cervix and vagina: A review of 63 cases in the post-DES era.

OBJECTIVE

To describe the clinical characteristics and oncologic outcomes of cervical and vaginal clear cell carcinoma (cCCC, vCCC) in the post-DES era.

METHODS

This is a retrospective cross-sectional study of patients diagnosed with cCCC and vCCC between 2000 and 2024. Cervical cancer was staged using the International Federation of Gynecology and Obstetrics (FIGO) 2018 system and categorized as early stage (IA1-IB2, IIA1), locally advanced (IB3, IIA2-IVA) and advanced (IVB). Overall survival (OS) and recurrence-free survival (RFS) were estimated with the Kaplan-Meier product-limit estimator and modeled via Cox proportional hazards regression.

RESULTS

A total of 63 patients were included: 51 cervical and 12 vaginal. Among cCCC, recurrence occurred in 21 patients (41.2%), with a median OS of 12.96 years (95% CI 8.83, 15.5). Early-stage disease was associated with a higher OS (p-value = 0.01) and RFS (p-value = 0.00049) compared to locally advanced and advanced disease. Lymph node metastasis was associated with poor OS (p-value = 0.0001) and RFS (p-value = 0.0113). In the vCCC group, recurrence was identified in 10 patients (83.3%), with a median OS of 3.26 years (95% CI 0.77, 6.75). Compared to cCCC, vCCC had worse prognosis with lower OS (p-value = 0.0009) and RFS (p-value = 0.0029).

CONCLUSION

Patients with cCCC have more favorable outcomes than those with vCCC, with stage and lymph node metastasis serving as predictors of survival outcomes in cCCC.