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Locoregional therapy for oligometastatic cervical cancer: a single-center retrospective study
  1. Hui Gao1,
  2. Haijing Wu2,
  3. Yue Zhang1,
  4. Zhiming Chen3,
  5. Zhongchun Qi1,
  6. Mingyi Wang4 and
  7. Peng Cheng1
  1. 1Department of Oncology, General Hospital of Western Theatre Command, Chengdu, Sichuan, China
  2. 2Department of Gynecological Oncology, Sichuan Cancer Hospital and Research Institute, Chengdu, Sichuan, China
  3. 3Department of Nuclear Medicine, General Hospital of Western Theatre Command, Chengdu, Sichuan, China
  4. 4Department of Obstetrics and Gynecology, General Hospital of Western Theatre Command, Chengdu, Sichuan, China
  1. Correspondence to Dr Hui Gao, Department of Oncology, General Hospital of Western Theatre Command, Chengdu, Sichuan 610083, China; gaoh_rad{at}foxmail.com

Abstract

Background Oligometastases are limited in number and extent, and therefore, are amenable to locoregional therapy.

Objective To analyze recurrence patterns, survival outcomes, and prognostic factors in patients with cervical cancer receiving locoregional therapy for oligometastases.

Methods The included patients had 1–3 extracranial oligometastases and received definitive radiotherapy, surgery, or ablation at a single institution between January 2007 and May 2022. Outcomes were evaluated using the Kaplan-Meier method. Prognostic factors were examined using the Cox proportional hazards model, and tumor growth rates were predicted by non-linear regression.

Results We identified 56 patients who presented with an oligometastatic disease to the supraclavicular fossa (n=19), lung (n=33), or other sites (n=4). Totals of 30 (53.6%), 41 (73.2%), 47 (83.9%), and 52 (92.9%) patients were diagnosed 1, 2, 3, and 4 years after cervical cancer diagnosis, respectively. Seven patients were simultaneously treated for para-aortic or pelvic recurrences. After a median follow-up of 24 months (range 1–86), the 3-year local recurrence-free rate in patients with supraclavicular versus non-supraclavicular oligometastases was 100% vs 93.5%. The 3-year overall survival rate was 40.1% vs 55.2% (p=0.04). Ten (17.9%) patients experienced new oligometastatic progression in a median of 8 months (range 4–14). Multivariate analysis showed that tumor size was the only prognostic factor for overall survival, with a 3-year overall survival rate of 91.7% vs 21.6% (≤15 mm vs >15 mm, p<0.001). Nineteen (86.4%) of 22 lesions diagnosed within 6 months of the last negative CT scan had a maximum diameter of ≤15 mm, and the predicted interval of tumor growth to 15 mm was 5.8 months.

Conclusion Locoregional therapy for cervical cancer oligometastases can achieve long-term survival, especially in patients with small lesions (≤15 mm). Better follow-up mode after cervical cancer treatment and system therapy for oligometastases should be further explored.

  • Cervical Cancer
  • Neoplasm Metastasis

Data availability statement

Data are available upon reasonable request.

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Data availability statement

Data are available upon reasonable request.

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Footnotes

  • HG and HW are joint first authors.

  • HG and HW contributed equally.

  • Contributors HG: responsible for the overall content as the guarantor, conceptualization, supervision, project administration; HW: investigation, writing-original draft preparation; YZ: investigation, data curation; ZC: methodology, resources; ZQ: formal analysis; MW: validation; PC: writing-reviewing and editing.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.