title: Predictors of Survival in Patients With FIGO Stage IVB Cervical Cancer.
abstract: OBJECTIVE
  The aim of this study was to identify prognostic factors and establish a model for predicting life expectancy in International Federation of Gynecology and Obstetrics stage IVB cervical cancer patients.
  
  
  METHODS
  The baseline characteristics and outcome data of patients with stage IVB cervical cancer between May 1994 and October 2014 were collected and retrospectively reviewed. A Cox proportional hazards regression model was used to identify independent predictors of survival in stage IVB cervical cancer patients.
  
  
  RESULTS
  A total of 107 patients were included in our database. The median overall survival (OS) period was 16 months. Multivariate analysis revealed that the metastatic site (hazards ratio, 3.09; 95% confidence interval, 1.94-4.88; P < 0.0001) and a white blood cell (WBC) count exceeding 10,000/μL (hazards ratio, 2.02; 95% confidence interval, 1.19-3.30; P = 0.0102) were significant prognostic factors in terms of OS. Patient survival was inversely correlated with the number of these prognostic factors possessed. When the patients were divided into 3 prognostic groups, the median OS of the patients with 0, 1, or 2 poor prognostic factors was 26, 12, and 7 months, respectively. Among the patients with WBC counts of less than 10,000/μL, treatment with radiotherapy resulted in improved survival compared with chemotherapy or palliative care alone. In contrast, radiotherapy had minimal effects on survival in patients with WBC counts of greater than 10,000/μL.
  
  
  CONCLUSIONS
  The metastatic site and an elevated WBC count are significant prognostic factors in patients with stage IVB cervical cancer. Our prognostic model composed of these 2 clinical variables might enable physicians to predict survival more accurately.
authors.affiliation: Departments of *Obstetrics and Gynecology, and †Radiation Oncology, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Sasano
authors.forename: Seiji
authors.initials: S
authors.lastname: Mabuchi
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Kuroda
authors.forename: Ryoko
authors.initials: R
authors.lastname: Takahashi
authors.forename: Katsumi
authors.initials: K
authors.lastname: Kozasa
authors.forename: Fumiaki
authors.initials: F
authors.lastname: Isohashi
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Yoshioka
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Ogawa
authors.forename: Tadashi
authors.initials: T
authors.lastname: Kimura
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality* / Q000556:secondary / Q000628:therapy; D002294:Carcinoma, Squamous Cell / Q000401:mortality* / Q000556:secondary / Q000628:therapy; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D002583:Uterine Cervical Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy