Sophie Espenel1, Max Adrien Garcia2, Julien Langrand-Escure3, Alexis Vallard3, Jane Chloé Trone3, Chloé Rancoule3, Nicolas Vial3, Pablo Moreno-Acosta4, Céline Chauleur5, Claire Boutet6, Michel Peoc Apos H7, Nathalie Prevot-Bitot8, Jean Baptiste Guy3, Nicolas Magné3. 1. Department of Radiotherapy, Lucien Neuwirth Cancer Institute, Saint-Priest-en-Jarez, France, sophie.espenel@gmail.com. 2. Public Health Department, Lucien Neuwirth Cancer Institute, Saint-Priest-en-Jarez, France. 3. Department of Radiotherapy, Lucien Neuwirth Cancer Institute, Saint-Priest-en-Jarez, France. 4. Research Group in Cancer Biology, National Cancer Institute, Bogotá, Colombia. 5. Department of Obstetrics and Gynecology, Saint-Etienne University Hospital Medical Center, Saint-Priest-en-Jarez, France. 6. Department of Radiology, Saint-Etienne University Hospital Medical Center, Saint-Priest-en-Jarez, France. 7. Department of Pathology, Saint-Etienne University Hospital Medical Center, Saint-Priest-en-Jarez, France. 8. Department of Nuclear Medicine, Saint-Etienne University Hospital Medical Center, Saint-Priest-en-Jarez, France.
Abstract
OBJECTIVES: The aim of this study was to identify and compare prognostic factors, management strategies, and outcomes of very locally advanced cervical cancer (CC) (i.e., stage IVA) and metastatic CC (i.e., stage IVB). METHOD: A retrospective review was conducted based on all consecutive patients treatedfor stage IV CC in a comprehensive cancer care centre between 2004 and 2017. RESULTS: Sixty-eight patients were included. Performance status (PS) was ≥2 for 35.9%. Median age at diagnosis was 60.5. There were 24 stage IVA CC (35.3%) and 44 stage IVB CC (64.7%). Seventeen patients with stage IVB CC had only para-aortic lymph node metastases (38.6%), 13 had only distant metastases (29.5%), and 14 had both (31.8%). Patients with stage IVA CC experienced a radiotherapy with curative intent (n = 14, 58.3%) +/- concomitant chemotherapy, or a palliative treatment (n = 10, 41.7%). Twenty-three patients with stage IVB CC received a prior chemotherapy (52.3%), 11 a primary concomitant chemoradiation (25%), and 10 a palliative treatment (22.7%). The mean follow-up was 18.0 months. The 5-year overall survival was 5.1% for stage IVA (95% CI = 0.7-33.9), and 10.5% for stage IVB (95% CI = 3.7-29.7). In multivariate analysis, PS >1 was identified as a poor prognostic factor of disease-specific survival for stage IVA CC. PS >1 and pelvic lymph node involvement were identified as poor prognostic factors of overall survival and disease-specific survival for stage IVB CC. CONCLUSIONS: In daily clinical practice, outcomes of stages IV CC are poor. Treatment of advanced and metastatic CC remains challenging. New management strategies are needed, as well as efficient preventive strategies.
OBJECTIVES: The aim of this study was to identify and compare prognostic factors, management strategies, and outcomes of very locally advanced cervical cancer (CC) (i.e., stage IVA) and metastatic CC (i.e., stage IVB). METHOD: A retrospective review was conducted based on all consecutive patients treatedfor stage IV CC in a comprehensive cancer care centre between 2004 and 2017. RESULTS: Sixty-eight patients were included. Performance status (PS) was ≥2 for 35.9%. Median age at diagnosis was 60.5. There were 24 stage IVA CC (35.3%) and 44 stage IVB CC (64.7%). Seventeen patients with stage IVB CC had only para-aortic lymph node metastases (38.6%), 13 had only distant metastases (29.5%), and 14 had both (31.8%). Patients with stage IVA CC experienced a radiotherapy with curative intent (n = 14, 58.3%) +/- concomitant chemotherapy, or a palliative treatment (n = 10, 41.7%). Twenty-three patients with stage IVB CC received a prior chemotherapy (52.3%), 11 a primary concomitant chemoradiation (25%), and 10 a palliative treatment (22.7%). The mean follow-up was 18.0 months. The 5-year overall survival was 5.1% for stage IVA (95% CI = 0.7-33.9), and 10.5% for stage IVB (95% CI = 3.7-29.7). In multivariate analysis, PS >1 was identified as a poor prognostic factor of disease-specific survival for stage IVA CC. PS >1 and pelvic lymph node involvement were identified as poor prognostic factors of overall survival and disease-specific survival for stage IVB CC. CONCLUSIONS: In daily clinical practice, outcomes of stages IV CC are poor. Treatment of advanced and metastatic CC remains challenging. New management strategies are needed, as well as efficient preventive strategies.
Authors: Eva Meixner; Line Hoeltgen; Philipp Hoegen; Laila König; Nathalie Arians; Laura L Michel; Katharina Smetanay; Carlo Fremd; Andreas Schneeweiss; Jürgen Debus; Juliane Hörner-Rieber Journal: Technol Cancer Res Treat Date: 2022 Jan-Dec