4.6 Article

Local treatment improves survival in patients with stage IVB cervical cancer

Journal

GYNECOLOGIC ONCOLOGY
Volume 165, Issue 3, Pages 538-545

Publisher

ACADEMIC PRESS INC ELSEVIER SCIENCE
DOI: 10.1016/j.ygyno.2022.04.013

Keywords

Cervical cancer; Distant metastasis; Surgery; Radiotherapy; Survival

Funding

  1. Commission Young and Middle-aged Talents Training Project of Fujian Health Commission [2021GGB027]
  2. Key Medical and Health Projects in Xiamen [3502Z20209002]

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This study evaluated the value of local treatment in stage IVB cervical cancer patients and found that the addition of local surgery or radiotherapy to chemotherapy can improve survival outcomes.
Objective. To evaluate the value of local treatment in stage IVB cervical cancer (CC). Methods. Patients diagnosed with stage IVB CC between 2010 and 2015 were included using the data from the Surveillance, Epidemiology, and End Results program. Propensity score matching (PSM) was used to balance the clinicopathological variables of patients. Multivariate Cox regression analyses were performed to analyze the risk factors associated with cause-specific survival (CSS). Results. We identified 960 patients in this study, all patients had received chemotherapy. Of these patients, 818 patients were treated with local treatment (852%), including 724 (88.5%) and 94 (11.5%) patients receiving radiotherapy (RT) alone and surgery f RT, respectively. Local treatment was the independent prognostic factor associated with better CSS. Before PSM, patients who received RT (hazard ratio [HR] 0.633,95% confidence interval [CI] 0.517-0.775, P < 0.001) or surgery (HR 0391, 95% CI 0277-0.552, P < 0.001) were independently associated with a better CSS compared to those with no local treatment. The 3-years CSS rate was 14.4%, 32.4%, and 54.8% in no local treatment, RT alone, and surgery groups, respectively (P < 0.001). Similar results were found after PSM. Patients receiving RT (HR 0.643, 95% CI 0.436-0.947, P - 0.025) and surgery (HR 0.146. 95% CI 0.052-0.410, P < 0.001) had better CSS compared to patients with no local treatment after PSM. While similar CSS was shown between RT alone cohort and the surgery cohort (HR 0.756, 95% CI 0.454-1260, P - 0284). Conclusions. The addition of local surgery or RT to chemotherapy appears to confer improved survival outcomes in patients with stage IVB CC. (C) 2022 Elsevier Inc. All rights reserved.

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