Long-term results and prognostic factors of patients with cervical carcinoma treated with concurrent chemoradiotherapy

• Published in: Clinical & translational oncology Vol. 13; no. 7; pp. 504 - 508
• Main Authors: Reig, Ana, Membrive, Ismael, Foro, Palmira, Sanz, Xavier, Rodríguez, Núria, Lozano, Joan, Lacruz, Martí, Quera, Jaume, Fernández-Velilla, Enric, Algara, Manuel
• Format: Journal Article
• Language: English
• Published: Milan Springer Milan 01-07-2011
• Subjects: Adenocarcinoma - secondary; Adenocarcinoma - therapy; Adult; Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Brachytherapy; Carcinoma, Squamous Cell - secondary; Carcinoma, Squamous Cell - therapy; Combined Modality Therapy; Female; Follow-Up Studies; Humans; Lymphatic Metastasis; Male; Medicine; Medicine & Public Health; Middle Aged; Neoplasm Recurrence, Local - pathology; Neoplasm Recurrence, Local - therapy; Oncology; Prognosis; Retrospective Studies; Survival Rate; Time Factors; Uterine Cervical Neoplasms - pathology; Uterine Cervical Neoplasms - therapy; Advanced cervical cancer; Overall survical; Radiochemotherapy
• ISSN: 1699-048X; 1699-3055
• DOI: 10.1007/s12094-011-0688-8

Aims and background
To evaluate the predictive factors of recurrence in cervical cancer treated with radical radiochemotherapy.
Methods
A retrospective analysis of 56 women was performed. Response was assessed using the RECIST response. Overall survival and disease-free survival curves were estimated by the Kaplan-Meier method and the Cox proportional hazards model was used to analyse predictors of recurrence.
Results
Local recurrence was documented in 16 patients and distant metastases in 15. The Kaplan-Meier survival probabilities were 95.1±6.4% at 3 years and 80.4±13.1% at 5 years and the Kaplan-Meier curve values for disease-free survival were 60.3±14.3% at 3 years and 53.0±15.7% at 5 years. Thirty-five patients were alive and 21 patients died, 19 from metastatic disease and 2 from other causes. Complete response after chemoradiation therapy, squamous cell carcinoma and tumour size ≤4 cm were significantly associated with outcome. In the Cox regression model, tumour size >4 cm (hazard ratio 7.48; 95% CI 2.71–20.6;
p
<0.001) and partial response (hazard ratio 7.09; 95% CI 2.82–17.8;
p
<0.001) were predictive factors for disease-free survival and partial response (hazard ratio 3.7; 95% CI 1.3–10.1;
p
<0.001) and non-squamous cell carcinoma (hazard ratio 3.5; 95% CI 1.2–9.7;
p
<0.001) were predictive factors for overall survival.
Conclusions
Non-squamous histology and partial response were independent prognostic factors for overall survival and tumour size and partial response were independent prognostic variables for 5-year disease survival.