Prognostic factors in locally advanced cervical cancer with pelvic lymph node metastasis.

Autor: Pinto PJJ; Department of Radiation Oncology, AC Camargo Cancer Center, Sao Paulo, Brazil., Chen MJ; Department of Radiation Oncology, AC Camargo Cancer Center, Sao Paulo, Brazil., Santos Neto E; Department of Radiation Oncology, AC Camargo Cancer Center, Sao Paulo, Brazil., Faloppa CC; Department of Gynecologic Oncology, AC Camargo Cancer Center, Sao Paulo, Brazil., De Brot L; Department of Pathology, AC Camargo Cancer Center, São Paulo, Brazil., Guimaraes APG; Department of Medical Oncology, AC Camargo Cancer Center, Sao Paulo, Brazil., da Costa AABA; Department of Medical Oncology, AC Camargo Cancer Center, Sao Paulo, Brazil., Baiocchi G; Department of Gynecologic Oncology, AC Camargo Cancer Center, Sao Paulo, Brazil glauco.baiocchi@accamargo.org.br.
Jazyk: angličtina
Zdroj: International journal of gynecological cancer : official journal of the International Gynecological Cancer Society [Int J Gynecol Cancer] 2022 Mar; Vol. 32 (3), pp. 239-245.
DOI: 10.1136/ijgc-2021-003140
Abstrakt: Objective: To evaluate the prognostic impact of clinical and pathological variables and patterns of recurrence in patients with locally advanced cervical cancer with pelvic lymph node involvement (stage IIIC1 according to the 2018 FIGO Staging System).
Methods: We retrospectively analyzed 62 patients with locally advanced cervical cancer treated with curative intent with radiotherapy associated with chemotherapy in AC Camargo Cancer Center from January 2007 to December 2018.
Results: Lymph node involvement was assessed by CT, MRI and positron emission tomography (PET)/CT in 28 (45.2%), 20 (32.3%) and 14 (22.6%) patients, respectively. The median tumor size was 5.0 cm and 72.6% of cases were squamous cell carcinomas. The median number of positive pelvic lymph nodes was three, and the median size of lymph nodes was 24 mm. Twenty-two (35.5%) patients had recurrence and 50% had only one site of recurrence. The sites of recurrence were pelvic, para-aortic and distant in 12 (19.4%), 6 (9.7%) and 16 (25.8%) patients, respectively. The 3 year overall and disease-free survival were 70.8% and 64.6%, respectively. Patients with adenocarcinoma had worse disease-free survival (HR 2.38; 95% CI 1.01 to 5.60; p=0.047) and overall survival (HR 2.99; 95% CI 1.14 to 7.75; p=0.025) compared with squamous cell carcinoma. In multivariate analysis, metastatic pelvic lymph node size of >2.5 cm (HR 4.38; 95% CI 1.65 to 11.6; p=0.003) and incomplete response to radiotherapy (HR 5.14; 95% CI 1.60 to 16.4; p=0.006) maintained the negative impact for overall survival.
Conclusions: We found that pelvic lymph node size and incomplete response to radiotherapy negatively impact overall survival in patients with advanced cervical cancer with pelvic lymph node involvement. This finding may help to stratify risk in this group of patients.
Competing Interests: Competing interests: None declared.
(© IGCS and ESGO 2022. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze: MEDLINE