Okazawa-Sakai Mika, Mabuchi Seiji, Isohashi Fumiaki, Kawashima Atsushi, Yokoi Eriko, Ogawa Kazuhiko, Kimura Tadashi
Department of Gynecological Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan.
Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Suita, Japan.
J Obstet Gynaecol Res. 2017 Nov;43(11):1743-1750. doi: 10.1111/jog.13446. Epub 2017 Aug 17.
To investigate the predictors of distant relapse in International Federation of Gynecology and Obstetrics (FIGO) stage IIB-IVA cervical cancer patients treated with definitive radiotherapy (RT).
The clinical data of 219 patients with FIGO stage IIB-IVA cervical cancer treated with definitive RT between January 1997 and December 2011 were retrospectively reviewed. The cumulative distant relapse, progression-free survival (PFS) and overall survival (OS) rates were calculated using the Kaplan-Meier method and compared using the log-rank test. A Cox proportional hazards regression model was used to investigate the predictors of distant relapse in patients.
Following treatment with definitive RT, 61 of the 219 (27.9%) patients developed distant relapse with median PFS and OS rates of 9.9 and 32.8 months, and estimated five-year PFS and OS rates of 4.9% and 21.3%, respectively. Multivariate analysis revealed that pelvic node metastasis, pretreatment leukocytosis and pretreatment neutrophilia were significant predictors of distant relapse. The risk of developing distant relapse was found to be associated with the number of predictors that the patients displayed: the estimated five-year distant relapse rates of the patients with no predictors, one predictor and two predictors were 20.3%, 35.5% and 88.9%, respectively.
Roughly 28% of patients with FIGO stage IIB-IVA cervical cancer developed distant relapse after definitive RT. Pelvic lymph node metastasis and pretreatment leukocytosis/neutrophilia are independent predictors of distant relapse.
探讨接受根治性放疗（RT）的国际妇产科联盟（FIGO）IIB-IVA期宫颈癌患者远处复发的预测因素。
回顾性分析1997年1月至2011年12月期间接受根治性RT治疗的219例FIGO IIB-IVA期宫颈癌患者的临床资料。采用Kaplan-Meier法计算累积远处复发率、无进展生存期（PFS）和总生存期（OS），并采用对数秩检验进行比较。采用Cox比例风险回归模型研究患者远处复发的预测因素。
根治性RT治疗后，219例患者中有61例（27.9%）发生远处复发，中位PFS和OS分别为9.9个月和32.8个月，估计5年PFS和OS分别为4.9%和21.3%。多因素分析显示，盆腔淋巴结转移、治疗前白细胞增多和治疗前中性粒细胞增多是远处复发的重要预测因素。发现远处复发风险与患者表现出的预测因素数量有关：无预测因素、有一个预测因素和有两个预测因素的患者估计5年远处复发率分别为20.3%、35.5%和88.9%。
约28%的FIGO IIB-IVA期宫颈癌患者在根治性RT后发生远处复发。盆腔淋巴结转移和治疗前白细胞增多/中性粒细胞增多是远处复发的独立预测因素。
