Prognostic Factors and Treatment Outcome for Patients with Stage IVB Cervical Cancer

Abstract

Aim: We report a retrospective evaluation for patients with stage IVB cervical cancer in order to identify survival rates and to improve our current practice.

Patients and methods: We analyzed 85 patients with stage IVB cervical cancer. For patients appropriate for radical treatment, a combination of external-beam radiotherapy and intracavitary brachytherapy was delivered with/without chemotherapy. Patients with distant metastasis were treated using systemic chemotherapy or palliative radiotherapy.

Results: Forty-two patients were treated using radiotherapy alone, 31 using chemotherapy followed by radiotherapy, eight using chemotherapy alone, and four using best supportive care. The 5-year overall survival rate was 9.9%. Multivariate analysis revealed leukocytosis and a poor performance status were independent prognostic factors. Of the 43 patients without these prognostic factors, patients with only lymph node metastasis had a 5-year overall survival rate of 40.5%.

Conclusion: Radical treatment should be considered in patients who have only lymph rode metastasis and are without leukocytosis and a poor performance status.

Keywords: Cervical cancer; PS; leukocytosis; prognostic factor; stage IVB.