J Gynecol Oncol.  2016 Nov;27(6):e55. 10.3802/jgo.2016.27.e55.

A prediction model of survival for patients with bone metastasis from uterine cervical cancer

Affiliations
  • 1Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan. yukiharu@sap-cc.go.jp
  • 2Department of Obstetrics and Gynecology, Hokkaido University School of Medicine, Sapporo, Japan.
  • 3Division of Pathology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan.

Abstract


OBJECTIVE
The aim of the study was to establish a predictive model of survival period after bone metastasis from cervical cancer.
METHODS
A total of 54 patients with bone metastasis from cervical cancer were included in the study. Data at the time of bone metastasis diagnosis, which included presence of extraskeletal metastasis, performance status, history of any previous radiation or chemotherapy, the number of bone metastases, onset period, and treatment were collected. Survival data were analyzed using Kaplan-Meier method and Cox proportional hazards model.
RESULTS
The median survival period after diagnosis of bone metastasis was 22 weeks (5 months). The 26- and 52-week survival rates after bone metastasis were 36.5% and 15.4%, respectively. Cox regression analysis showed that extraskeletal metastasis (hazard ratio [HR], 6.1; 95% CI, 2.2 to 16.6), performance status of 3 to 4 (HR, 7.8; 95% CI, 3.3 to 18.2), previous radiation or chemotherapy (HR, 3.3; 95% CI, 1.4 to 7.8), multiple bone metastases (HR, 1.9; 95% CI, 1.0 to 3.5), and a bone metastasis-free interval of <12 months (HR, 2.5; 95% CI, 1.2 to 5.3) were significantly and independently related to poor survival. A prognostic score was calculated by adding the number of each significant factor. The 26-week survival rates after diagnosis of bone metastasis were 70.1% in the group with a score ≤2, 46.7% in the group with a score of 3, and 12.5% in the group with a score ≥4 (p<0.001).
CONCLUSION
This scoring system provided useful prognostic information on survival of patients with bone metastasis of cervical cancer.

Keyword

Bone Metastasis; Performance Status; Prognosis; Uterine Cervical Neoplasms

MeSH Terms

Adult
Aged
Aged, 80 and over
Bone Neoplasms/*mortality/*secondary/therapy
Female
Humans
Kaplan-Meier Estimate
Middle Aged
Neoplasm Staging
Proportional Hazards Models
Survival Rate
United States/epidemiology
Uterine Cervical Neoplasms/*pathology/therapy
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