Article Text
Abstract
Introduction/Background*The primary objective of this project was to identify the independent clinical-pathological variables associated with the death after relapse in patients with stage IB1 cervical cancer who underwent radical hysterectomy. The secondary objective was to analysis survival post-relapse in these patients.
Methodology Based on the SUCCOR study’s database . Patients were eligible if they had a relapse (local, distant or both) after underwent a radical hysterectomy in a European Institution for stage IB1 cervical cancer (FIGO 2009), from January 1st, 2013 to December 31st, 2014. To identify variables independently associated with death in these patients, we calculated the odds ratio using simple logistic regression models and subsequently a multivariate backward stepwise procedure. For the secondary end point we calculated Kaplan-Meyer and Cox regression using the results of the univariate and multivariate analysis .
Result(s)*A total of 126 patients were selected, women who died were more likely to have tumors >2cm on the clinical examination (OR, 3.50; 95% CI, 1.35- 9.08) and to have a stromal infiltration higher than 1/3 (OR, 6.30; 95% CI, 1.31- 30.00). In contrast, the histologic subtype of adenocarcinoma and treatment with Bevacizumab were found as protective factors against death (OR, 0.32; 95% CI, 0.11- 0.95) and (OR, 0.23; 95% CI, 0.05- 0.99) respectively.
The mean time of relapse of our population was 22.94 months and the median of survival after relapse was 18.5 months.
Patients with tumors > 2cm on the clinical examination had a 3.39-times higher hazard of death after relapse (HR, 3.39; 95% CI, 1.52- 7.53) and the distant/both location of relapse had 2.23- times higher hazard of death (HR, 2.23; 95% CI, 1.14- 4.36)
The 2-years survival rates after relapse were 76% for tumors <2cm, 50.0% tumors >2cm on the clinical examination, 76% for local relapse and 47% for distant/both location relapse.
Conclusion*The tumor size on clinical examination, the location of relapse, the histologic subtype and the treatment with Bevacizumab, modify the risks of death after relapse on patients with cervical cancer IB1. Tumor >2cm on clinical examination and distant recurrences have a shorter survival time after relapse