Cervical adenocarcinoma: current diagnostic and treatment approaches

Cervical cancer ranks fourth among all oncological diseases and second among reproductive system malignancies (13.3%), following breast cancer (47.8%). Invasive adenocarcinoma, originating from glandular epithelium, accounts for 21–25% of newly diagnosed cervical cancer cases. Human papillomavirus (HPV) is responsible for up to 92% of cervical cancer cases. This review aims to summarize current approaches to the classification and treatment of cervical adenocarcinoma and identify unresolved challenges. Modern treatment strategies rely on distinguishing HPV-associated and HPV-independent tumors, allowing for more precise adenocarcinoma subtyping and tailored therapeutic strategies. Treatment algorithms for conventional-type adenocarcinoma have been developed, taking into account its specific morphological features, which enable appropriate adjuvant therapy at early disease stages. Significant progress has been made with the introduction of immunotherapy and antibody–drug conjugates into systemic treatment. However, therapeutic advancements for HPV-independent adenocarcinomas remain limited, except for Her2-positive tumors. Retrospective studies highlight differences in cancer outcomes, whereas emerging genetic mutation data may pave the way for more targeted treatment approaches as oncology moves into the era of precision medicine. Currently, treatment approaches for endocervical adenocarcinoma remain similar to those used for squamous cell carcinoma.