J Gynecol Oncol.
2022 May;33(3):e32. 10.3802/jgo.2022.33.e32.
Oncologic outcomes according to the level of disease burden in patients with metachronous distant metastases from uterine cervical cancer: a Korean Radiation Oncology Group study (KROG 18-10)
- Affiliations
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- 1Department of Radiation Oncology, Korea University Ansan Hospital, Ansan, Korea
- 2Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- 3Department of Radiation Oncology, School of Medicine, Kyungpook National University, Daegu, Korea
- 4Department of Radiation Oncology, Research Institute and Hospital, National Cancer Center, Goyang, Korea
- 5Department of Radiation Oncology, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
- 6Department of Radiation Oncology, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Korea
- 7Department of Radiation Oncology, Guro Hospital Korea University Medical College, Seoul, Korea
- KMID: 2536990
- DOI: http://doi.org/10.3802/jgo.2022.33.e32
Abstract
Objective
This study aimed to evaluate the oncologic outcomes according to disease burden in uterine cervical cancer patients with metachronous distant metastases.
Methods
Between 2005 and 2015, 163 patients with metachronous distant metastases from uterine cervical cancer after receiving a definitive therapy were evaluated at seven institutions in Korea. Low metastatic burden was defined as less than 5 metastatic sites, whereas high metastatic burden was others. Each metastasis site was divided based on the lymph node (LN) and organs affected. The overall survival (OS) and progression-free survival (PFS) were assessed. Cox proportional hazards models, including other clinical variables, were used to evaluate the survival outcomes.
Results
The median follow-up duration was 22.2 months (range: 0.3–174.8 months). Para-aortic LNs (56.4%), lungs (26.4%), supraclavicular LNs (18.4%), and peritoneum (13.5%) were found to be the common metastasis sites. Among 37 patients with a single metastasis, 17 (45.9%) had LN metastases and 20 (54.1%) had organ metastases. The 1- and 2-year OS rates were 73.9% and 55.0%, respectively, whereas the PFS rates were 67.2% and 42.9%, respectively. SCC Ag after recurrence and high metastatic burden were significant factors affecting the OS (p=0.004 and p<0.001, respectively). Distant organ recurrence, short disease-free interval (≤2 years), and high metastatic burden were unfavorable factors for PFS (p=0.003, p=0.011, and p=0.002, respectively).
Conclusion
A favorable oncologic outcome can be expected by performing salvage treatments in selected patients with a long disease-free interval, low metastatic burden, and/or lymphatic-only metastasis.
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