Outcome of stage IVA cervical cancer patients with disease limited to the pelvis in the era of chemoradiation

A Gynecologic Oncology Group study

Peter G. Rose, Shamshad Ali, Charles W. Whitney, Rachelle Lanciano, Frederick Stehman

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Objectives: To evaluate the outcome of stage IVA cervical cancer treated with radiation and concurrent cisplatin-based chemotherapy. Methods: We conducted a retrospective study of stage IVA cervical cancer patients from four trials (Gynecologic Oncology Group protocols 56, 85, 120, and 165) treated with radiotherapy with or without concurrent cisplatin-based chemotherapy. Patient records were reviewed for demographic and tumor features, treatment, and progression-free survival (PFS) and overall survival (OS). Stage IVA patients were compared to stage IIIB patients from these same studies. Results: Among the 51 stage IVA patients studied, 92% were stage IVA on the basis of bladder involvement. The median PFS was 10.1 months (95% CI = 6.3-14.5 months) and median OS was 21.2 months (95% CI = 13.3-30.5 months). The 3 year survival was 32%. On univariate analysis, only advanced age was associated with OS (p = 0.0115) but age had only marginal effect on PFS (p = 0.083). Pathologic proven pelvic nodal metastasis was of marginal significance for both PFS and OS, p = 0.059 and 0.064, respectively. Despite similar patient characteristics, the use of cisplatin-based chemotherapy had no impact on PFS or OS but was underpowered to address this question. When compared to stage IIIB patients, stage IVA patients had a poorer performance status (p = 0.0231), larger tumor size (p = 0.0302), and more frequent bilateral parametrial involvement (0.0063). Conclusion: Patients with stage IVA disease had poor median survival of only 21 months with only 32% 3 year survival. Stage IVA patients have larger tumor size, more bilateral parametrial involvement, and poorer survival when compared to stage IIIB patients.

Original languageEnglish
Pages (from-to)542-545
Number of pages4
JournalGynecologic Oncology
Volume121
Issue number3
DOIs
StatePublished - Jun 1 2011

Fingerprint

Pelvis
Uterine Cervical Neoplasms
Survival
Disease-Free Survival
Cisplatin
Drug Therapy
Neoplasms
Urinary Bladder
Radiotherapy
Retrospective Studies
Demography
Radiation
Neoplasm Metastasis

Keywords

  • Hydronephrosis
  • Performance status
  • Stage IVA cervical cancer
  • Survival

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Oncology

Cite this

Outcome of stage IVA cervical cancer patients with disease limited to the pelvis in the era of chemoradiation : A Gynecologic Oncology Group study. / Rose, Peter G.; Ali, Shamshad; Whitney, Charles W.; Lanciano, Rachelle; Stehman, Frederick.

In: Gynecologic Oncology, Vol. 121, No. 3, 01.06.2011, p. 542-545.

Research output: Contribution to journalArticle

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title = "Outcome of stage IVA cervical cancer patients with disease limited to the pelvis in the era of chemoradiation: A Gynecologic Oncology Group study",
abstract = "Objectives: To evaluate the outcome of stage IVA cervical cancer treated with radiation and concurrent cisplatin-based chemotherapy. Methods: We conducted a retrospective study of stage IVA cervical cancer patients from four trials (Gynecologic Oncology Group protocols 56, 85, 120, and 165) treated with radiotherapy with or without concurrent cisplatin-based chemotherapy. Patient records were reviewed for demographic and tumor features, treatment, and progression-free survival (PFS) and overall survival (OS). Stage IVA patients were compared to stage IIIB patients from these same studies. Results: Among the 51 stage IVA patients studied, 92{\%} were stage IVA on the basis of bladder involvement. The median PFS was 10.1 months (95{\%} CI = 6.3-14.5 months) and median OS was 21.2 months (95{\%} CI = 13.3-30.5 months). The 3 year survival was 32{\%}. On univariate analysis, only advanced age was associated with OS (p = 0.0115) but age had only marginal effect on PFS (p = 0.083). Pathologic proven pelvic nodal metastasis was of marginal significance for both PFS and OS, p = 0.059 and 0.064, respectively. Despite similar patient characteristics, the use of cisplatin-based chemotherapy had no impact on PFS or OS but was underpowered to address this question. When compared to stage IIIB patients, stage IVA patients had a poorer performance status (p = 0.0231), larger tumor size (p = 0.0302), and more frequent bilateral parametrial involvement (0.0063). Conclusion: Patients with stage IVA disease had poor median survival of only 21 months with only 32{\%} 3 year survival. Stage IVA patients have larger tumor size, more bilateral parametrial involvement, and poorer survival when compared to stage IIIB patients.",
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AB - Objectives: To evaluate the outcome of stage IVA cervical cancer treated with radiation and concurrent cisplatin-based chemotherapy. Methods: We conducted a retrospective study of stage IVA cervical cancer patients from four trials (Gynecologic Oncology Group protocols 56, 85, 120, and 165) treated with radiotherapy with or without concurrent cisplatin-based chemotherapy. Patient records were reviewed for demographic and tumor features, treatment, and progression-free survival (PFS) and overall survival (OS). Stage IVA patients were compared to stage IIIB patients from these same studies. Results: Among the 51 stage IVA patients studied, 92% were stage IVA on the basis of bladder involvement. The median PFS was 10.1 months (95% CI = 6.3-14.5 months) and median OS was 21.2 months (95% CI = 13.3-30.5 months). The 3 year survival was 32%. On univariate analysis, only advanced age was associated with OS (p = 0.0115) but age had only marginal effect on PFS (p = 0.083). Pathologic proven pelvic nodal metastasis was of marginal significance for both PFS and OS, p = 0.059 and 0.064, respectively. Despite similar patient characteristics, the use of cisplatin-based chemotherapy had no impact on PFS or OS but was underpowered to address this question. When compared to stage IIIB patients, stage IVA patients had a poorer performance status (p = 0.0231), larger tumor size (p = 0.0302), and more frequent bilateral parametrial involvement (0.0063). Conclusion: Patients with stage IVA disease had poor median survival of only 21 months with only 32% 3 year survival. Stage IVA patients have larger tumor size, more bilateral parametrial involvement, and poorer survival when compared to stage IIIB patients.

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