Different prognosis of stage IIIB cervical cancer patients with lower third of vaginal invasion and those without

Gynecol Oncol. 2021 Jul;162(1):50-55. doi: 10.1016/j.ygyno.2021.04.005. Epub 2021 Apr 12.

Abstract

Objective: Previous studies have evaluated the prognostic factors of patients with stage IIIB cervical cancer. However, there was only one study evaluating the relationship between LTI (lower third of vaginal invasion) and the prognosis of the patients with stage IIIB cervical cancer. Our research aimed to assess different therapeutic outcomes of the stage IIIB CCP (cervical cancer patients) with or without LTI.

Methods: From December 2007 to December 2014, patients with FIGO (International Federation of Gynecology and Obstetrics, 2009) stage IIIB cervical cancer admitted and treated in Zhejiang Cancer Hospital were enrolled and evaluated in this retrospective research. Different clinicopathological variables and treatment outcomes were analyzed by using multivariate and univariate Cox regression models and chi-square or Fisher's exact test.

Results: The number of enrolled patients was 622, among which 74 cases were with LTI and 548 without. The two- and five-year OS (overall survival) rates in non-LTI group were 79.9% and 58.9%, and the OS rates in LTI group were 68.9% and 38.8%, respectively (P = 0.001). The two- and five-year PFS (progression-free survival) rates in non-LTI group were 63.3% and 53.1%, and the PFS rates in LTI group were 45.9% and 37.0% respectively (P = 0.002). Multivariate Cox regression analysis indicated that histological type, total treatment time, hydronephrosis, and treatment protocol were factors significantly affecting the PFS rates in stage IIIB CCP, and OS rates were associated with histological type, hydronephrosis, treatment protocol, and LTI.

Conclusions: Our study showed that stage IIIB CCP with LTI had worse prognosis than those without LTI.

Keywords: Cervical cancer; Lower third of vaginal invasion; Prognosis; Stage IIIB.

MeSH terms

  • Brachytherapy
  • Female
  • Humans
  • Middle Aged
  • Neoplasm Invasiveness
  • Neoplasm Staging
  • Prognosis
  • Progression-Free Survival
  • Proportional Hazards Models
  • Retrospective Studies
  • Survival Rate
  • Uterine Cervical Neoplasms / pathology*
  • Uterine Cervical Neoplasms / radiotherapy
  • Vagina / pathology*