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EV373/#749  Selective local ablative therapy (LAT) for oligometastatic cervical cancer- a weapon for chemo de-escalation
  1. Christopher Walker1,
  2. Carson Edwards1,
  3. Micah Thornton2,
  4. Jayanthi Lea1 and
  5. Kevin Albuquerque3
  1. 1University of Texas Southwestern Medical Center, Department of Obstetrics and Gynecology, Dallas, USA
  2. 2Thornton Statistical Consulting (DBA), Dallas, USA
  3. 3University of Texas Southwestern Medical Center, Radiation Oncology, Dallas, USA

Abstract

Introduction Integrating local ablative therapy (LAT) with systemic treatment for oligometastatic cancer has demonstrated improved outcomes for many organ sites but has not been extensively studied in cervical cancer. This study sought to characterize the incidence and outcomes of patients with oligometastatic cervical cancer (OMCC) as a prelude to incorporating LAT with the goal of deescalating the need for excessive chemotherapy.

Methods This is an observational study of 176 patients with metastatic and recurrent cervical cancer who underwent systemic therapy. Patients were classified as OMCC or polymetastatic (PMCC) based on the presence of ≤5 or >5 lesions, respectively. OMCC was further categorized into synchronous or metachronous based on the presence of metastatic disease within 6 months of diagnosis or >6 months, respectively. Univariate and multivariate analysis, as well as Kaplan Meier curves were performed for PFS and OS.

Results Of 176 patients, 129 had recurrent disease and 47 with stage IVB/metastatic disease. 84 patients had OMCC and 92 had PMCC. OMCC patients demonstrated improved PFS (p=0.027), and OS (p=0.025) compared to patients with PMCC. 66 patients were classified as metachronous OMCC versus 19 as synchronous, where metachronous patients had improved overall survival benefit (0.0041).

Conclusion/Implications Almost half (47%) of patients had OMCC, who demonstrated a PFS and OS benefit compared to patients with PMCC. Since patients with OMCC seem to have improved outcomes, incorporating LAT into the treatment paradigm might allow us to improve long term disease control and deescalate chemotherapy usage. This may be important in geographic areas with limited access to sophisticated systemic therapies.

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