Cancer Management and Research (Aug 2019)
Impact of sites versus number of metastases on survival of patients with organ metastasis from newly diagnosed cervical cancer
Abstract
Zhuomin Yin,1,2 Huarong Tang,1 Li Li,1 Juan Ni,1 Shuhui Yuan,1 Hanmei Lou,1 Ming Chen21Department of Gynecologic Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou 310022, People’s Republic of China; 2Department of Radiation Oncology (Zhejiang Key Laboratory of Radiation Oncology), Zhejiang Cancer Hospital, Hangzhou 310022, People’s Republic of ChinaCorrespondence: Ming ChenDepartment of Radiation Oncology, Zhejiang Cancer Hospital, No. 1 Banshan East Road,Hangzhou 310022, People’s Republic of ChinaTel +86 5 718 812 8172Fax +86 5 718 812 2508Email [email protected]: The aim of this study was to investigate the potential associations of the sites and the number of specific metastases with survival in patients newly diagnosed with cervical cancer.Methods: Medical records of patients with organ metastases of newly diagnosed cervical cancer at Zhejiang Cancer Hospital from October 2006 to December 2016 were reviewed retrospectively. Survival times were compared using the Kaplan-Meier method. Variables associated with survival were identified using univariate and multivariate Cox proportional hazards models.Results: A total of 99 patients with newly diagnosed organ metastatic cervical cancer were identified. Median follow-up was 11.6 months (range, 0.5–114.7 months). Median overall survival (OS) time was 11.7 months from diagnosis, with 1, 2, and 5-year OS rates of 48.2%, 22.8%, and 12.6%, respectively. The most common site of organ metastasis was bone (36.8%), followed by lung (32.8%) and liver (24%). In univariate analysis, OS rates were better for bone metastasis than visceral metastasis (P=0.013), oligometastasis than non-oligometastasis (P=0.003) and single organ metastasis than multiple organ metastases (P=0.016), while that for liver metastasis was poorer than non-liver metastases (P<0.001). In multivariate analysis, liver metastasis (hazard ratio [HR] =4.02; 95% confidence interval [CI], 1.15-14.05, P=0.029) was significantly and independently related to poor overall survival.Conclusion: Our data revealed the site of metastasis is associated with overall survival of patients with newly diagnosed organ metastatic cervical cancer, with liver metastasis signifying particularly poor overall survival. Individualized treatments should be administered to patients depending on the specific metastatic sites.Keywords: uterine cervical neoplasm, survival, organ metastasis, metastatic site, number of metastases