Prognostic factors in women with cervical cancer stage IIIC1r treated with concurrent chemoradiotherapy

• Published in: The journal of obstetrics and gynaecology research Vol. 46; no. 7; pp. 1165 - 1172
• Main Authors: Ryu, Jung Min, Choi, Yoon Seok, Bae, Jin Young
• Format: Journal Article
• Language: English
• Published: Kyoto, Japan John Wiley & Sons Australia, Ltd 01-07-2020; Wiley Subscription Services, Inc
• Subjects: Age; Cervical cancer; Chemoradiotherapy; Chemotherapy; concurrent chemoradiotherapy; lymph node; Lymph nodes; Medical prognosis; Medical records; Metastases; neoplasm metastasis; neoplasm staging; Patients; Prognosis; Radiation therapy; Squamous cell carcinoma; uterine cervical neoplasm; neoplasm metastasis; neoplasm staging; concurrent chemoradiotherapy; prognosis; lymph node; uterine cervical neoplasm
• ISSN: 1341-8076; 1447-0756
• DOI: 10.1111/jog.14305

Aim
The purpose of this study was to evaluate the prognostic factors of patients with stage IIIC1r cervical cancer who underwent concurrent chemoradiotherapy.
Methods
A total of 134 patients treated with chemoradiotherapy for cervical cancer with pelvic and/or paraaortic lymph node metastasis (PALNM) were enrolled in this study. Clinical variables were investigated through review of the patients' medical records.
Results
The 5‐year overall survival (OS) rate in patients with stage IIICr cervical cancer was 70.5%. Age, PALNM, parametrial invasion, T stage, pelvic side wall invasion, differentiation, lymphovascular space involvement and high squamous cell carcinoma antigen level (>8 ng/mL) were prognostic factors for survival. The 5‐year OS rate of patients with stage IIIC1r was 74.5%, and that of stage IIIC2r was 38.1% (P‐value = 0.012). The 5‐year OS rate of patients with stage IIIC1r with the presence of pelvic side wall invasion was 48.3% and that in its absence was 83.0% (P‐value < 0.001). The 5‐year OS rate of patients with stage IIIC1r with the presence of parametrial invasion was 68.9% and that in its absence was 82.4% (P‐value = 0.031). In multivariable analysis via backward conditional modeling, age, PALNM and pelvic side wall invasion were independent prognostic factors for survival of stage IIICr. Age and pelvic side wall invasion were independent prognostic factors for survival of stage IIIC1r cervical cancer.
Conclusion
In stage IIICr cervical cancer, patients with PALNM, and/or pelvic side wall invasion can expect to have a poor prognosis. Particularly, pelvic side wall invasion in stage IIIC1r is an independent prognosis factor.