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Ovarian, uterine, and cervical cancer patients with distant metastases at diagnosis: most common locations and outcomes

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Abstract

To determine the location patterns of distant metastases at initial staging and outcomes of ovarian, uterine, and cervical cancer patients. Data were obtained from the SEER database from 2010 to 2015. Analyses were performed using Kaplan–Meier and multivariate Cox proportional hazard methods. Of 3035 patients (median age: 63, range: 17–95) with stage IV gynecologic cancer, ovarian, uterine, and cervical cancers were present in 42%, 40%, and 18% of the cohort. The proportion of lung, liver, bone and brain metastases were identified in 38%, 57%, 4%, and 1% of ovarian cancer patients, 62%, 22%, 13%, and 3% of uterine cancer patients, and 59%, 16%, 23%, and 2% of cervical cancer patients, respectively. The 5-year disease-specific survival for all patients was 19%. Those with liver metastases had survival rates of 26% compared to 15% for lung, 13% for bone, and 6% for brain (p < 0.0001). Patients with ovarian, uterine, and cervical cancers had survival rates of 28%, 12%, and 12%, respectively (p < 0.0001). On multivariate analysis, brain metastasis (HR = 1.64, 95% CI 1.21–2.22, p < 0.01), uterine (HR = 1.77, 95 CI 1.56–2.02, p < 0.0001) and cervical (HR = 1.35, 95% CI 1.11–1.63, p < 0.01) cancers, and lack of insurance (HR = 1.41, 95% CI 1.16–1.73, p < 0.001) were independent predictors for poorer survival. Age, year, region, and race did not affect prognosis. Stage IV ovarian cancer most frequently metastasizes to the liver, whereas uterine and cervical cancers spread more to the lung. Overall, these patients have poor prognosis, particularly those with uterine or cervical primary disease or brain metastases.

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Acknowledgements

This research was supported by The Denise Cobb Hale and Dr. John A Kerner Funds. The sponsor had no role in the study design, production of data, writing of the report, or the decision to submit for publication.

Funding

This research was supported by The Denise Cobb Hale and Dr. John A Kerner Funds. The sponsor had no role in the study design, production of data, writing of the report, or the decision to submit for publication.

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Authors and Affiliations

  1. University of California, Irvine School of Medicine, Irvine, CA, USA

    Austin B. Gardner

  2. UCSD Rebecca and John Moores Cancer Center, La Jolla, CA, USA

    Lindsey M. Charo & Ramez N. Eskander

  3. Palo Alto Medical Foundation Research Institute, Palo Alto, CA, USA

    Amandeep K. Mann

  4. Stanford University School of Medicine, Stanford, CA, USA

    Daniel S. Kapp

  5. California Pacific & Palo Alto Medical Foundation/Sutter Health Research Institute, San Francisco, CA, USA

    John K. Chan

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  1. Austin B. Gardner
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  2. Lindsey M. Charo
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  5. Ramez N. Eskander
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Correspondence to John K. Chan.

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Gardner, A.B., Charo, L.M., Mann, A.K. et al. Ovarian, uterine, and cervical cancer patients with distant metastases at diagnosis: most common locations and outcomes. Clin Exp Metastasis 37, 107–113 (2020). https://doi.org/10.1007/s10585-019-10007-0

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  • DOI: https://doi.org/10.1007/s10585-019-10007-0

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