de Foucher Tiphaine, Hennebert Cecile, Dabi Yohan, Ouldamer Lobna, Lavoué Vincent, Dion Ludivine, Canlorbe Geoffroy, Bolze Pierre Adrien, Golfier François, Akladios Cherif, Lecointre Lise, Kerbage Yohan, Collinet Pierre, Bricou Alexandre, Carcopino Xavier, Huchon Cyrille, Raimond Emilie, Graesslin Olivier, Owen Clémentine, Touboul Cyril, Ballester Marcos, Darai Emile, Bendifallah Sofiane
Department of Gynaecology and Obstetrics, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), 75020 Paris, France.
Departement of Obstetrics, Gynaecology and Reproductive Medecine, Centre Hospitalier Intercommunal de Créteil, 94000 Créteil, France.
J Clin Med. 2020 Nov 12;9(11):3646. doi: 10.3390/jcm9113646.
The standard of care for patients with advanced cervical cancer (ACC) includes platinum-based chemotherapy. The concept of platinum sensitivity is a major prognostic factor for patients with ovarian cancer. The aim of this study was to validate the applicability of the platinum sensitivity concept to ACC patients, and to estimate its prognostic interest in terms of overall survival (OS) and pattern of recurrence (location, timing). Data of women with histologically proven FIGO 2019 stages IB3-IV ACC, treated between May 2000 and November 2017 with platinum-based regimens, were retrospectively abstracted from 12 institutions from the FRANCOGYN Group. Respective 3-year OSs were 52% (95% CI: 40.8%-66.8%), 21.6% (95% CI: 12.6%-37.2%), and 14.6% (95% CI: 4.2%-50.2%), in case of recurrence <6 months, between 6 and 17 months, and ≥18 months ( < 0.001). Risk of metastatic or multisite recurrence was significantly higher in case of recurrence <6 months, and risk of local or isolated infradiaphragmatic nodal recurrence was significantly higher in case of recurrence >18 months ( < 0.001). In multivariate analysis, platinum sensitivity status was a strong prognostic factor for OS after recurrence, independent of histological grade, lympho-vascular space involvement, final lymph node status, and treatment. Platinum sensitivity status may help to classify patients in three prognostic subgroups for OS after recurrence, and appears to be a strong prognostic factor correlated to the pattern of recurrence.
晚期宫颈癌（ACC）患者的标准治疗方案包括铂类化疗。铂敏感性概念是卵巢癌患者的一个主要预后因素。本研究的目的是验证铂敏感性概念在ACC患者中的适用性，并评估其在总生存期（OS）和复发模式（部位、时间）方面的预后价值。对2000年5月至2017年11月期间在FRANCOGYN集团的12家机构接受铂类方案治疗的、组织学确诊为FIGO 2019分期IB3-IV期ACC的女性患者的数据进行了回顾性提取。复发时间<6个月、6至17个月和≥18个月的患者，其3年总生存率分别为52%（95%CI：40.8%-66.8%）、21.6%（95%CI：12.6%-37.2%）和14.6%（95%CI：4.2%-50.2%）（P<0.001）。复发时间<6个月的患者发生转移或多部位复发的风险显著更高，复发时间>18个月的患者发生局部或孤立的膈下淋巴结复发的风险显著更高（P<0.001）。在多因素分析中，铂敏感性状态是复发后总生存期的一个强有力的预后因素，独立于组织学分级、淋巴血管间隙浸润、最终淋巴结状态和治疗。铂敏感性状态可能有助于将复发后的患者分为三个总生存期预后亚组，并且似乎是与复发模式相关的一个强有力的预后因素。
