Munetaka Takekuma1, Keita Mori2, Tetsuji Iida3, Kazuko Kurihara4, Motoaki Saitou5, Hideki Tokunaga6, Kei Kawana7, Masae Ikeda8, Toyomi Satoh9, Toshiaki Saito10, Etsuko Miyagi11, Yutaka Nagai12, Akiko Furusawa13, Yoshiaki Kawano14, Kouichiro Kawano15, Tsutomu Tabata16, Yukinobu Ota17, Ryoji Hayase18, Mikio Mikami8, Toru Sugiyama19. 1. Department of Gynecology, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumicho, Suntogun, Shizuoka, 411-8777, Japan. m.takekuma@scchr.jp. 2. Clinical Research Center, Shizuoka Cancer Center, Shizuoka, Japan. 3. Department of Gynecology, Kanagawa Cancer Center, Kanagawa, Japan. 4. Department of Gynecology, Saitama Cancer Center, Saitama, Japan. 5. Department of Obstetrics and Gynecology, The Jikei University Hospital, Tokyo, Japan. 6. Department of Gynecology, Tohoku University Hospital, Miyagi, Japan. 7. Department of Obstetrics and Gynecology, The University of Tokyo Hospital, Tokyo, Japan. 8. Department of Obstetrics and Gynecology, Tokai University Hospital, Kanagawa, Japan. 9. Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan. 10. Department of Gynecology, National Kyushu Cancer Center, Fukuoka, Japan. 11. Department of Obstetrics and Gynecology, Yokohama City University Hospital, Kanagawa, Japan. 12. Department of Obstetrics and Gynecology, University of the Ryukyus Hospital, Okinawa, Japan. 13. Department of Obstetrics and Gynecology, University Hospital of Medicine, Tokyo Medical and Dental University, Tokyo, Japan. 14. Department of Gynecology and Obstetrics, Kyushu University Hospital, Fukuoka, Japan. 15. Department of Obstetrics and Gynecology, Kurume University Hospital, Fukuoka, Japan. 16. Department of Obstetrics and Gynecology, Mie University Hospital, Mie, Japan. 17. Department of Gynecology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan. 18. Department of Gynecology, NHO Fukuyama Medical Center, Hiroshima, Japan. 19. Department of Obstetrics and Gynecology, Iwate Medical University Hospital, Iwate, Japan.
Abstract
PURPOSE: This study aimed at evaluating the applicability of the concept of platinum sensitivity to recurrent cervical cancer. METHODS: The clinical information of patients with recurrent cervical cancer, who were initially treated with platinum-based chemotherapy and received second-line platinum-based chemotherapy at the time of recurrence between January 2008 and December 2012, was retrospectively reviewed. RESULTS: A total of 677 patients from 71 medical centers were analyzed. The median overall survival (OS) for patients with platinum-free interval (PFI) of <6, 6-11, 12-17, and ≥18 months was 12.1 (95% CI 11.0-14.1) months, 17.4 (15.5-20.4) months, 20.2 (17.9-27.6) months, and 29.9 (26.7-36.0) months, respectively (P < 0.0001, log-rank). The best cut-off value of PFI that affected OS was 7 months, analyzed by the minimum P value method. The median progression-free survival (PFS) for patients with less than and more than PFI of 7 months was 6.2 months (95% CI 4.8-9.3) and 21.0 months (18.9-24.8) (P < 0.0001, log-rank), respectively, and the median OS for patients with less than and more than PFI of 7 months was 12.3 months (11.2-14.1) and 24.2 months (20.8-25.8) (P < 0.0001, log-rank). Multivariate analysis revealed that PFI (P < 0.0001, HR 0.449, 95% CI 0.369-0.548) alone had a statistically significant association with OS. CONCLUSIONS: This study showed that the concept of platinum sensitivity could be applied to recurrent cervical cancer and PFI could be one of the independent prognostic factors for patients with recurrent cervical cancer who have previously been treated with platinum-based chemotherapy.
PURPOSE: This study aimed at evaluating the applicability of the concept of platinum sensitivity to recurrent cervical cancer. METHODS: The clinical information of patients with recurrent cervical cancer, who were initially treated with platinum-based chemotherapy and received second-line platinum-based chemotherapy at the time of recurrence between January 2008 and December 2012, was retrospectively reviewed. RESULTS: A total of 677 patients from 71 medical centers were analyzed. The median overall survival (OS) for patients with platinum-free interval (PFI) of <6, 6-11, 12-17, and ≥18 months was 12.1 (95% CI 11.0-14.1) months, 17.4 (15.5-20.4) months, 20.2 (17.9-27.6) months, and 29.9 (26.7-36.0) months, respectively (P < 0.0001, log-rank). The best cut-off value of PFI that affected OS was 7 months, analyzed by the minimum P value method. The median progression-free survival (PFS) for patients with less than and more than PFI of 7 months was 6.2 months (95% CI 4.8-9.3) and 21.0 months (18.9-24.8) (P < 0.0001, log-rank), respectively, and the median OS for patients with less than and more than PFI of 7 months was 12.3 months (11.2-14.1) and 24.2 months (20.8-25.8) (P < 0.0001, log-rank). Multivariate analysis revealed that PFI (P < 0.0001, HR 0.449, 95% CI 0.369-0.548) alone had a statistically significant association with OS. CONCLUSIONS: This study showed that the concept of platinum sensitivity could be applied to recurrent cervical cancer and PFI could be one of the independent prognostic factors for patients with recurrent cervical cancer who have previously been treated with platinum-based chemotherapy.