Identifying clinical and treatment factors on survival outcomes of cervical cancer: Sawanpracharak Hospital
Keywords:
Cervical cancer, overall survival rate, progression-free survival, prognostic factorsAbstract
Backgrounds Cervical cancer is the fourth most common cancer in women globally, including Thailand. The main treatments for locally advanced cervical cancer are concurrent chemoradiation and brachytherapy. Several risk factors are associated with survival outcomes.
Objectives To identify clinical, pathology, and treatment factors that impact on overall survival (OS) and progression-free survival (PFS) in locally advanced cervical cancer.
Materials and Methods A retrospective study of an explorative prognostic factor research was conducted in locally advanced cervical cancer patients treated in Sawanpracharak Hospital from 2017 to 2019. Kaplan-Meier and Log-rank test were used for survival analysis. Cox regression was used for univariate and multivariate analysis to identify the prognostic factors. P-value <0.05 was considered statistically significant.
Result There were 179 patients. The mean age was 53 years old. The 3-year overall survival (OS) was 75%, 72.2%, 44.4-66.7% and 46.2% and the 3-year progression-free survival (PFS) was 93%, 74%, 33.3-80% and 38.5% for stage I, II, III and IVA respectively. Multivariable analysis identified risk factors for poor OS included initial hemoglobin level < 10 g/dl (HR 2.63; 95% CI, 1.41-4.89, p=0.002) non-squamous cell histology (HR 2.07; 95% CI, 1.09-3.93, p=0.026) and tumor size ≥4 cm (HR 2.4; 95% CI, 1.05-5.58, p=0.038). Factors associated with worse PFS included non-squamous cell histology (HR 2.40; 95% CI, 1.31-4.39, p=0.004) and tumor size ≥4 cm (HR 3.59; 95% CI, 1.34-9.63, p=0.011). There was no statistically significant difference in the PFS or OS between those who received 5 cycles or less chemotherapy and total treatment time 56 or more days.
Conclusion Initial hemoglobin level < 10 g/dl was a factor associated with worse overall survival, whereas histological cell type and tumor size were prognostic factors associated with overall survival and progression-free survival outcomes in cervical cancer.
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