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Outcomes associated with treatment to all sites of disease in patients with stage IVB cancer of the cervix.
- Source :
-
International journal of gynecological cancer : official journal of the International Gynecological Cancer Society [Int J Gynecol Cancer] 2023 May 01; Vol. 33 (5), pp. 683-691. Date of Electronic Publication: 2023 May 01. - Publication Year :
- 2023
-
Abstract
- Objective: The use of chemoradiation in patients with stage IVB cancer of the cervix was evaluated to determine if definitive treatment offers benefit.<br />Methods: 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.<br />Results: 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).<br />Conclusions: 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.<br />Competing Interests: Competing interests: None declared.<br /> (© IGCS and ESGO 2023. Re-use permitted under CC BY-NC. No commercial re-use. Published by BMJ.)
Details
- Language :
- English
- ISSN :
- 1525-1438
- Volume :
- 33
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- International journal of gynecological cancer : official journal of the International Gynecological Cancer Society
- Publication Type :
- Academic Journal
- Accession number :
- 36963801
- Full Text :
- https://doi.org/10.1136/ijgc-2022-004224