title: Analysis of the clinicopathological prognosis of stage IVb cervical carcinoma.
abstract: The aim of this study was to evaluate the clinicopathological prognostic factors in patients with stage IVb cervical carcinoma (CC). All patients with stage IVb CC included in the study were diagnosed from 1997 to 2006 at the National Cancer Center Hospital. We retrospectively examined clinicopathological parameters in these patients, including the efficacy of chemotherapy. Survival was evaluated using Kaplan-Meier curve analysis and log-rank test. The independent prognostic factors found to be predictive of survival in univariate and multivariate analysis were evaluated using a Cox's proportional hazard model. Thirty-six patients (median age 54 years) were diagnosed with stage IVb CC. The median progression-free survival and overall survival were 3.8 and 11.1 months, respectively. As initial treatment, 4 patients underwent hysterectomy, 13 received chemotherapy, 17 received radiotherapy, and the remaining 2 patients refused treatment. A total of 21 patients received chemotherapy, of which 13 were initial cases, 7 were persistent/recurrence cases, and 1 was a postoperative adjuvant case; 15 patients were never treated with chemotherapy. On univariate analysis, poor performance status (PS) and non-chemotherapy groups were considered poor prognostic factors, respectively. On multivariate analysis, poor PS (p=0.007; hazard ratio, 2.64) and non-chemotherapy (p=0.016; hazard ratio, 6.03) were independent prognostic factors of survival, respectively. Poor PS and non-chemotherapy groups were found to have poor prognosis in patients with stage IVb CC. Chemotherapy may improve the survival for stage IVb CC.
authors.affiliation: Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan. nishio_shin@hotmail.com
authors.forename: Shin
authors.initials: S
authors.lastname: Nishio
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Katsumata
authors.forename: Koji
authors.initials: K
authors.lastname: Matsumoto
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tanabe
authors.forename: Kan
authors.initials: K
authors.lastname: Yonemori
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Kohno
authors.forename: Chikako
authors.initials: C
authors.lastname: Shimizu
authors.forename: Masashi
authors.initials: M
authors.lastname: Ando
authors.forename: Takahiro
authors.initials: T
authors.lastname: Kasamatsu
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Fujiwara
mesh_terms: D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology*