Clinical determinants of survival from stage IB cervical cancer in an Inner-City Hospital

• Published in: Journal of the National Medical Association Vol. 90; no. 5; pp. 303 - 308
• Main Authors: THOMS, W. W, UNGER, E. R, CARISIO, R, NISENBAUM, R, SPANN, C. O, HOROWITZ, I. R, REEVES, W. C
• Format: Journal Article
• Language: English
• Published: Thorofare, NJ Slack 01-05-1998; Elsevier Limited; National Medical Association
• Subjects: Adenocarcinoma - mortality; Adenocarcinoma - pathology; Adenocarcinoma - therapy; African Americans - statistics & numerical data; Biological and medical sciences; Carcinoma, Adenosquamous - mortality; Carcinoma, Adenosquamous - pathology; Carcinoma, Adenosquamous - therapy; Carcinoma, Squamous Cell - mortality; Carcinoma, Squamous Cell - pathology; Carcinoma, Squamous Cell - therapy; Cervical cancer; Combined Modality Therapy; Female; Female genital diseases; Georgia - epidemiology; Gynecology. Andrology. Obstetrics; Humans; Incidence; Medical sciences; Middle Aged; Neoplasm Staging; Poverty Areas; Risk Factors; Survival Analysis; Survival Rate; Tumors; Urban Population; Uterine Cervical Neoplasms - mortality; Uterine Cervical Neoplasms - pathology; Uterine Cervical Neoplasms - therapy; United States; North America; America; Georgia; Human; Carcinoma; Prognosis; Stage classification; Urban area; Malignant tumor; Uterine cervix; Epidemiology; Survival; Ethnic group; Female genital diseases; Risk factor; Female; Clinical investigation; Uterine cervix diseases; Public health
• ISSN: 0027-9684; 1943-4693

This study reviewed a high-risk population of inner-city women with FIGO (International Federation of Gynecologists and Obstetricians) stage Ib cervical cancer diagnosed and treated at a single institution between 1986 and 1993. The patient age at diagnosis averaged 49 years, and most of the patients were black (83%). Squamous carcinomas predominated (75%). Radiotherapy was the most frequent treatment modality (49%), followed by surgery (38%) and combined radiation/surgery (13%). The Kaplan-Meier estimated 4-year survival for all patients completing treatment was 81%. Increased survival was significantly associated with therapy. The Kaplan-Meier estimated survival at 26 months (the time of the last death in radiotherapy patients) was 66% for radiotherapy patients and 100% for those treated with surgery. Radiotherapy patients differed from surgery patients in age, tumor size, and pelvic lymph node status, indicating that treatment selection bias could explain the observed difference in survival. Age, race, histology, and cervical lesion size were not significantly associated with survival.