Introduction/Background*The purpose of this study is to determine the disease, and treatment characteristics of stage IB-IV cervical cancer associated with survival differences.
Methodology A retrospective chart review on cervical cancer patients in BC between January 1, 2010 and December 31, 2017 was done. Demographic data, treatment details and covariates of prognostic signifikance were collected. Data analysis included logistic regression, multivariate Cox regressions, pairwise comparisons and 2-tailed t tests as appropriate.
Result(s)*780 patients were examined (stage I 31.5%, II 20.0%, III 34.5%, IV 3.3%). Survival outcomes are presented for the cohort as a whole, and stratified by stage of diagnoses in table 1 and 2 respectively. Decreased overall survival was associated with lymphovascular invasion and p16 negativity, however when stratified by stage, LVI significantly impacted survival in stage I to III patients only. Increased survival was associated with surgical resection, radical radiotherapy (RT), brachytherapy, concurrent cisplatin and 5 weeks of chemotherapy (vs. <5 weeks). When stratified by stage, surgical resection only improved survial in stage I patients, with no significant difference in any other stage. The use of radical RT, brachytherapy, and concurrent chemotherapy did not show survival differences in stage I disease, but did in stage II to IV. As a whole, peri-RT chemotherapy was not associated with survival benefit in adeno/adenosquamous carcinoma. 180 women recurred (23.1%) with mostly distant metastases (42.8%). There was lower incidence of recurrence after primary surgical resection in those with tumor size <2cm vs. tumors >2cm (4.1% vs 24.7%, p=0.0004). Though only 37.7% of recurrence/metastases was treated with first-line carboplatin/paclitaxel/bevacizumab, it was associated with better overall survival compared to other regimens (median OS 40.1 vs. 24.8 months, p=0.03).
Conclusion*A significant number of women had recurrence (23.1%), and LVI and p16 negativity is associated with poor survival. Surgical resection in stage I is associated with improved survival but not in stage II to IV. Use of radical chemoradiation treatment is associated with survival differences in stage II to IV disease, but not stage I. First line carboplatin/paclitaxel/bevacizumab for recurrence shows improves survival but only a small proportion of women received it.
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