Outcomes associated with treatment to all sites of disease in patients with stage IVB cancer of the cervix.
cervical cancer
neoplasm metastasis
radiotherapy
Journal
International journal of gynecological cancer : official journal of the International Gynecological Cancer Society
ISSN: 1525-1438
Titre abrégé: Int J Gynecol Cancer
Pays: England
ID NLM: 9111626
Informations de publication
Date de publication:
01 05 2023
01 05 2023
Historique:
medline:
3
5
2023
pubmed:
25
3
2023
entrez:
24
3
2023
Statut:
epublish
Résumé
The use of chemoradiation in patients with stage IVB cancer of the cervix was evaluated to determine if definitive treatment offers benefit. A database of 546 patients with cancer of the cervix treated between January 2005 and May 2021 at a tertiary academic medical center was reviewed retrospectively to identify patients with stage IVB disease. Log rank test, regression analysis, and the Kaplan-Meier method were used to identify and compare variables and estimate progression free survival and overall survival. Thirty-three patients with stage IVB cervical cancer were identified. Median age was 53 years (range 28-78). Pathology subtypes were squamous cell (n=22, 67%), adenocarcinoma (n=8, 24%), and clear cell (n=3, 9%). Metastases were classified as lymphatic (n=14, 42%) or hematogenous (n=19, 58%). Following treatment to all sites with chemoradiotherapy and selected use of surgery (n=23), six patients (26%, lymphatic n=4, hematogenous n=2) remained disease free for a median duration of 4 years (range 3-17 years). Recurrences in the remaining patients were distant (n=13) or local (n=4). All patients in the chemotherapy group (n=10, 100%) progressed. Kaplan-Meier analysis showed that median progression free survival was longer for patients treated at all disease sites than for patients treated with chemotherapy alone (19 vs 11 months, p=0.01). However, this was not the case for overall survival (49 vs 33 months, p=0.15). Patients with metastases limited to lymph nodes also had longer median progression free survival (22 vs 11 months, p=0.04) but not overall survival (p=0.68). Patients with stage IVB cancer of the cervix may benefit from treatment to all sites of disease, if feasible and safe, as demonstrated by improved progression free survival.
Identifiants
pubmed: 36963801
pii: ijgc-2022-004224
doi: 10.1136/ijgc-2022-004224
pmc: PMC10176349
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
683-691Informations de copyright
© IGCS and ESGO 2023. Re-use permitted under CC BY-NC. No commercial re-use. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
Références
Gynecol Oncol. 2022 Jun;165(3):538-545
pubmed: 35490033
J Natl Compr Canc Netw. 2020 Jun;18(6):660-666
pubmed: 32502976
Brachytherapy. 2021 Mar-Apr;20(2):361-367
pubmed: 33317966
Indian J Med Res. 2021 Aug;154(2):303-318
pubmed: 35295014
Radiother Oncol. 2005 Mar;74(3):235-45
pubmed: 15763303
JAMA Oncol. 2018 Sep 1;4(9):1288-1291
pubmed: 30054609
J Gynecol Oncol. 2010 Sep;21(3):186-90
pubmed: 20922142
Pract Radiat Oncol. 2020 Jul - Aug;10(4):220-234
pubmed: 32473857
Int J Gynecol Cancer. 2016 Mar;26(3):528-33
pubmed: 26825839
Cancer Treat Rev. 2003 Dec;29(6):471-88
pubmed: 14585258
Int J Radiat Oncol Biol Phys. 2012 Nov 1;84(3):741-7
pubmed: 22898382
Gynecol Oncol. 2018 Jan;148(1):132-138
pubmed: 29089122
Clin Cancer Res. 2015 Dec 15;21(24):5480-7
pubmed: 26672085
Int J Gynaecol Obstet. 2018 Oct;143 Suppl 2:22-36
pubmed: 30306584
Gynecol Oncol. 2003 Sep;90(3):572-6
pubmed: 13678726
Radiat Oncol. 2015 Apr 04;10:77
pubmed: 25884833
Int J Clin Oncol. 2004 Dec;9 Suppl 3:1-82
pubmed: 15818867
Eur J Gynaecol Oncol. 2007;28(1):33-8
pubmed: 17375703
In Vivo. 2021 Mar-Apr;35(2):1169-1176
pubmed: 33622917
Br J Radiol. 2010 Jul;83(991):554-68
pubmed: 20603408
Ann Oncol. 2017 Jul 1;28(suppl_4):iv72-iv83
pubmed: 28881916
J Gynecol Oncol. 2012 Jul;23(3):159-67
pubmed: 22808358
Int J Gynecol Cancer. 2016 Sep;26(7):1239-45
pubmed: 27643648
Int J Gynecol Cancer. 2021 Jan;31(1):59-65
pubmed: 33273018
Gynecol Oncol. 2020 Jan;156(1):100-106
pubmed: 31810653
Anticancer Res. 2016 Jul;36(7):3471-5
pubmed: 27354610
Clin Transl Radiat Oncol. 2018 Jan 11;9:48-60
pubmed: 29594251
Pract Radiat Oncol. 2018 Nov - Dec;8(6):e377-e385
pubmed: 30174248
Radiother Oncol. 2020 Jul;148:157-166
pubmed: 32388150
Cancer Res Treat. 2013 Sep;45(3):193-201
pubmed: 24155678
Gynecol Oncol Rep. 2022 Mar 23;40:100963
pubmed: 35345549