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Metastatic extent-specific prognosis of women with stage IVB cervical cancer: multiple versus single distant organ involvement

  • Gynecologic Oncology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

Despite the heterogeneity of anatomical sites that metastases may affect, within the current cancer staging schematic, stage IVB encompasses all distant metastasis. This study examined survival outcomes based on the extent of distant organ metastasis in stage IVB cervical cancer.

Methods

This retrospective cohort study utilized the National Cancer Institute’s Surveillance, Epidemiology, and End Result Program from 2010 to 2018. The study population included 1772 women with stage IVB cervical cancer who had tumor metastasis to one or more of the following four organs: bone, brain, liver, or lung. Overall survival was assessed based on the metastatic extent in multivariable analysis.

Results

The most common metastatic site was lung (68.3%) followed by bone (35.2%), liver (30.0%), and brain (1.2%). Multiple organ metastases were seen in 26.5% of study population, with lung / liver metastases being the most frequent combination pattern (9.6%) followed by lung / bone (9.4%), and lung / bone / liver (6.4%). A total of 1442 (81.4%) deaths occurred during the follow-up. The cohort-level median overall survival was 7 months, ranging from 3 months in all four organ metastases to 11 months in bone metastasis alone when stratified (absolute difference 8 months, P < 0.001). Multiple organ metastases were independently associated with nearly 50% increased all-cause mortality risk compared to single organ metastasis (adjusted-hazard ratio 1.51, 95% CI 1.34–1.70).

Conclusion

Survival outcomes in those with stage IVB cervical cancer with distant organ involvement can vary based on the extent of metastasis. Incorporation of single versus multiple distant organ metastasis into the cancer staging schema may be valuable (IVB1 versus IVB2).

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Data availability

All the data that support the findings of this study are publicly available in The National Cancer Institute’s Surveillance, Epidemiology, and End Results Program, and the dataset is available at http://seer.cancer.gov/.

References

  1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A (2018) Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 68(6):394–424

    Article  PubMed  Google Scholar 

  2. Arbyn M, Weiderpass E, Bruni L et al (2020) Estimates of incidence and mortality of cervical cancer in 2018: a worldwide analysis. Lancet Glob Health 8(2):e191–e203

    Article  PubMed  Google Scholar 

  3. Ginsburg O, Bray F, Coleman MP et al (2017) The global burden of women’s cancers: a grand challenge in global health. Lancet 389(10071):847–860

    Article  PubMed  Google Scholar 

  4. Cancer Stat Facts: Cervical Cancer. National Cancer Institute Surveillance, Epidemiology, and End Results Program. <https://seer.cancer.gov/statfacts/html/cervix.html>. Accessed 12/november/2021

  5. Benedet JL, Pecorelli S (2006) Why Cancer Staging? Int J Gynaecol Obstet 95(Suppl 1):S3

    Article  PubMed  Google Scholar 

  6. Cervical cancer. NCCN clinical practice guidelines in oncology, National Comprehensive Cancer Network. https://www.nccn.org/. Accessed 12/september/2021

  7. Bhatla N, Aoki D, Sharma DN, Sankaranarayanan R (2018) Cancer of the cervix uteri. Int J Gynaecol Obstet 143(Suppl 2):22–36

    Article  PubMed  Google Scholar 

  8. Nishio S, Matsuo K, Yonemoto K et al (2018) Race and nodal disease status are prognostic factors in patients with stage IVB cervical cancer. Oncotarget 9(64):32321–32330

    Article  PubMed  PubMed Central  Google Scholar 

  9. Oishi S, Kudaka W, Toita T et al (2016) Prognostic factors and treatment outcome for patients with stage ivb cervical cancer. Anticancer Res 36(7):3471–3475

    CAS  PubMed  Google Scholar 

  10. Usami T, Takahashi A, Matoda M et al (2016) Review of treatment and prognosis of stage IVB cervical carcinoma. Int J Gynecol Cancer 26(7):1239–1245

    Article  PubMed  Google Scholar 

  11. National Cancer Institute’s The Surveillance, Epidemiology, and End Results (SEER) Program. http://seer.cancer.gov/. Accessed 12/August/2021

  12. Zippin C, Lum D, Hankey BF (1995) Completeness of hospital cancer case reporting from the SEER Program of the National Cancer Institute. Cancer 76(11):2343–2350

    Article  CAS  PubMed  Google Scholar 

  13. National Cancer Registrars Association http://www.ncra-usa.org/. Accessed 12/August/2021

  14. Harlan LC, Hankey BF (2003) The surveillance, epidemiology, and end-results program database as a resource for conducting descriptive epidemiologic and clinical studies. J Clin Oncol 21(12):2232–2233

    Article  PubMed  Google Scholar 

  15. International Classification of Diseases for Oncology, 3rd Edition (ICD-O-3). World Health Organization. https://www.who.int/classifications/icd/adaptations/oncology/en/. Accessed 12/August/2021

  16. Gien LT, Beauchemin MC, Thomas G (2010) Adenocarcinoma: a unique cervical cancer. Gynecol Oncol 116(1):140–146

    Article  CAS  PubMed  Google Scholar 

  17. Cancer Genome Atlas Research N, Albert Einstein College of M, Analytical Biological S et al (2017) Integrated genomic and molecular characterization of cervical cancer. Nature 543(7645):378–384

    Article  Google Scholar 

  18. Galic V, Herzog TJ, Lewin SN et al (2012) Prognostic significance of adenocarcinoma histology in women with cervical cancer. Gynecol Oncol 125(2):287–291

    Article  PubMed  Google Scholar 

  19. Ghaferi AA, Schwartz TA, Pawlik TM (2021) STROBE reporting guidelines for observational studies. JAMA Surg 156(6):577–578

    Article  PubMed  Google Scholar 

  20. Quinn MA, Benedet JL, Odicino F et al (2006) Carcinoma of the cervix uteri FIGO 26th Annual Report on the results of treatment in gynecological cancer. Int J Gynaecol Obstet 95(Suppl 1):S43-103

    Article  PubMed  Google Scholar 

  21. Smith CB, Phillips T, Smith TJ (2017) Using the new ASCO clinical practice guideline for palliative care concurrent with oncology care using the TEAM approach. Am Soc Clin Oncol Educ Book 37:714–723

    Article  PubMed  Google Scholar 

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Funding

Ensign Endowment for Gynecologic Cancer Research (K.M.). The funder had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

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Authors and Affiliations

  1. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, 2020 Zonal Avenue, IRD 520, Los Angeles, CA, 90033, USA

    Sarah Joh, Caroline J. Violette, Varun U. Khetan, Amin Tavakoli, Neda D. Jooya, Lynda D. Roman & Koji Matsuo

  2. Keck School of Medicine, University of Southern California, Los Angeles, CA, USA

    Sarah Joh

  3. Division of Obstetrics, Gynecology and Gynecologic Subspecialties, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA

    Sigita S. Cahoon

  4. Department of Obstetrics and Gynecology, Faculty of Medicine, University of Freiburg, Freiburg, Germany

    Maximilian Klar

  5. Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA

    Lynda D. Roman & Koji Matsuo

Authors
  1. Sarah Joh
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  2. Caroline J. Violette
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  3. Varun U. Khetan
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  4. Amin Tavakoli
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  7. Maximilian Klar
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  8. Lynda D. Roman
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  9. Koji Matsuo
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Contributions

Conceptualization: KM; data curation: KM; formal analysis: KM; funding acquisition: KM and LDR; investigation: all authors; methodology: KM; project administration: KM; resources: KM; software: KM; supervision: MK and LDR; validation: KM; visualization: KM; writing—original draft: KM, SJ; writing—review & editing: all authors.

Corresponding author

Correspondence to Koji Matsuo.

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Conflict of interests

All were unrelated to the work: consultant, Quantgene (L.D.R.); none for others.

Ethical approval

University of Southern California (HS-16–00481).

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Not applicable.

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Abstract presentation: 2022 Society of Gynecologic Oncology Annual Meeting on Women’s Cancer, Phoenix, AZ, March 18–21, 2022.

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Joh, S., Violette, C.J., Khetan, V.U. et al. Metastatic extent-specific prognosis of women with stage IVB cervical cancer: multiple versus single distant organ involvement. Arch Gynecol Obstet 307, 533–540 (2023). https://doi.org/10.1007/s00404-022-06611-3

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  • DOI: https://doi.org/10.1007/s00404-022-06611-3

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