Lavanya Gurram1, Roshankumar Patil1, Supriya Chopra1, Amita Maheshwari2, T S Shylasree2, Sudeep Gupta3, Jaya Ghosh3, Seema Gulia3, Yogesh Ghadi4, Dheera A4, Umesh Mahantshetty5. 1. Department of Radiation Oncology, Tata Memorial Hospital, Homi Bhabha National Institute (HBNI) Mumbai, India. 2. Department of Surgical Oncology Tata Memorial Hospital, Homi Bhabha National Institute (HBNI) Mumbai, India. 3. Department of Medical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute (HBNI) Mumbai, India. 4. Department of Medical Physics, Tata Memorial Hospital, Homi Bhabha National Institute (HBNI) Mumbai, India. 5. Department of Radiation Oncology, Tata Memorial Hospital, Homi Bhabha National Institute (HBNI) Mumbai, India; Director, Homi Bhabha Cancer Hospital and Research Centre, Visakhapatnam, India. Electronic address: mahantshettyum@tmc.gov.in.
Abstract
OBJECTIVE(S): The objective of this study was to evaluate the clinical outcomes and prognostic factors affecting survival of cervical cancer patients presenting with lower third vaginal involvement. MATERIALS/ METHODS: The patients with histologically proven invasive cervical cancer with clinical FIGO-2009 stage IIIA and IIIB with lower one-third vaginal involvement, treated with radio (chemo) therapy between 2010 and 2016 at our institution were retrospectively analyzed. RESULTS: There were 118 cervical cancer patients with lower third vaginal involvement with median age of 56.5 years (Range: 33-77 years). Forty-five patients were of FIGO stage IIIA, 73 patients staged as stage IIIB at diagnosis with predominant squamous histology. At a median follow up of 30 months, 12 patients (10.1%) developed local vaginal recurrences and 4 patients (3.3%) had developed loco regional recurrences, 27 patients (23%) developed distant and 2 patients developed loco-regional and distant relapses. The 3- year DFS and OS rates were 61.5% and 69.8% respectively. The 3-year DFS and OS of patients with IIIA was significantly better than IIIB patients (71% vs 56%, p: 0.02 and 76% vs 66%, p: 0.01 respectively) on univariate analysis. Concurrent chemotherapy and absence of persistent disease emerged as independent predictors of survival on multi-variate analysis. CONCLUSION: The outcome of patients with FIGO IIIA is better than IIIB with lower vaginal involvement. Elderly patients, patients not receiving concomitant chemotherapy and presence of residual disease at BT are associated with poorer outcomes.
OBJECTIVE(S): The objective of this study was to evaluate the clinical outcomes and prognostic factors affecting survival of cervical cancerpatients presenting with lower third vaginal involvement. MATERIALS/ METHODS: The patients with histologically proven invasive cervical cancer with clinical FIGO-2009 stage IIIA and IIIB with lower one-third vaginal involvement, treated with radio (chemo) therapy between 2010 and 2016 at our institution were retrospectively analyzed. RESULTS: There were 118 cervical cancerpatients with lower third vaginal involvement with median age of 56.5 years (Range: 33-77 years). Forty-five patients were of FIGO stage IIIA, 73 patients staged as stage IIIB at diagnosis with predominant squamous histology. At a median follow up of 30 months, 12 patients (10.1%) developed local vaginal recurrences and 4 patients (3.3%) had developed loco regional recurrences, 27 patients (23%) developed distant and 2 patients developed loco-regional and distant relapses. The 3- year DFS and OS rates were 61.5% and 69.8% respectively. The 3-year DFS and OS of patients with IIIA was significantly better than IIIB patients (71% vs 56%, p: 0.02 and 76% vs 66%, p: 0.01 respectively) on univariate analysis. Concurrent chemotherapy and absence of persistent disease emerged as independent predictors of survival on multi-variate analysis. CONCLUSION: The outcome of patients with FIGO IIIA is better than IIIB with lower vaginal involvement. Elderly patients, patients not receiving concomitant chemotherapy and presence of residual disease at BT are associated with poorer outcomes.
Authors: Lele Zang; Qin Chen; Xiaozhen Zhang; Xiaohong Zhong; Jian Chen; Yi Fang; An Lin; Min Wang Journal: Cancer Manag Res Date: 2021-12-29 Impact factor: 3.989