Gastric-type Histology Independently Predicts Poor Survival in Surgically-treated Cervical Adenocarcinoma

<h3>Background/Aim:</h3> This study aimed to evaluate the clinicopathologic characteristics and prognostic impact of gastric-type histology in surgically-treated cervical adenocarcinoma. <h3>Patients and Methods:</h3> This retrospective cohort study included 309 patients with cervical adenocarcinoma who underwent primary surgery between 2011 and 2021. Histologic subtypes were classified as usual-type (n=280) and gastric-type (n=29). Clinicopathologic features and survival outcomes were compared. Multivariable Cox regression models were constructed adjusting for age and postoperative risk stratification. <h3>Results:</h3> Gastric-type tumors were associated with higher rates of locally advanced disease, lymphovascular space invasion, lymph node metastasis, parametrial invasion, and positive margins (all <i>p</i>&lt;0.01). Gastric-type histology was significantly associated with inferior progression-free survival (PFS) and overall survival (OS) (both <i>p</i>&lt;0.001). In multivariable analysis, gastric-type histology independently predicted worse PFS [adjusted hazard ratio (aHR)= 2.13, <i>p</i>=0.01] and OS (aHR=3.10, <i>p</i>=0.003). <h3>Conclusion:</h3> In surgically-treated cervical adenocarcinoma, gastric-type histology independently predicts inferior survival outcomes beyond established postoperative risk factors, supporting the need for histology-specific management strategies.