Outcomes associated with treatment to all sites of disease in patients with stage IVB cancer of the cervix

Shira Peleg Hasson, Shira Felder, Limor Helpman, Alexandra Taylor, Michal Shalamov, Sireen Abuakar, Smadar Bauer, Ronnie Shapira-Frommer, Inbal Greenhouse, Jacob Korach, Tatiana Rabin, Jeffrey Goldstein, Akram Saad*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Objective The use of chemoradiation in patients with stage IVB cancer of the cervix was evaluated to determine if definitive treatment offers benefit. 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. 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). 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.

Original languageEnglish
Pages (from-to)683-691
Number of pages9
JournalInternational Journal of Gynecological Cancer
Volume33
Issue number5
DOIs
StatePublished - May 2023

Funding

FundersFunder number
Parasol Foundation

    Keywords

    • cervical cancer
    • neoplasm metastasis
    • radiotherapy

    Fingerprint

    Dive into the research topics of 'Outcomes associated with treatment to all sites of disease in patients with stage IVB cancer of the cervix'. Together they form a unique fingerprint.

    Cite this