No abstract

Objectives: The incidence and mortality rates of cervical cancer in the world are 13.1/105 and 6.9/105, respectively. In India, it is estimated that there are 96,922 new cervical cancer cases and 60,078 deaths and ranked second among women cancers. The incidence and mortality rates are 14.7/105 and 9.2/105, respectively, although the incidence varies within Indian population. The majority of these cervical patients report at a late-stage of disease in health-care facility due to lack of awareness. A premier tertiary cancer hospital in Mumbai conducted the present survival-study. The aim of the study was to assess the various factors that determine the survival outcomes by age at diagnosis, role of comorbidities, stage of disease, and treatment. Material and Methods: The main source of information was patients’ medical records from which the data were abstracted, and active follow-up was undertaken. 1678 cases diagnosed between the years 2006 and 2008 at Tata Memorial Hospital are analyzed using actuarial method for obtaining survival rates and log-rank tests for comparison of survival groups. Results: The 5-year survival rate was 76.0% for those aged ≤50 years, 73.3% for non-residents, 74.4% for literates, and 81.8% for Christians and 72.5% for those with squamous cell carcinoma histology; those with no comorbidities had marginally better survival than their counter-parts. The survival rates were 83.5%, 80.6%, 66.0%, and 37.1% for Stage I, Stage II, Stage III, and Stage IV, respectively. The best survival outcomes were for those treated with only surgery (95.6%), or in combination with either radiotherapy (90.6%) or with radiotherapy and chemotherapy (85.5%). Involvement of either nodes/sites had poorer survival than those with no-involvement. In the multivariate analysis, only stage of the disease emerged as a significant prognosis factor. Conclusion: The study concluded that younger patients, early stage of disease, non-involvement of any sites/ nodes, and radiotherapy either alone or in combination with other treatment type provided better outcomes. Early detection and prevention strategies are keys to obtain better outcomes.

Background: Inflammation seems to play a very crucial role in the growth and progression of many cancers. It has been reported that a peripheral blood count has been used as a cost-effective and simple parameter of systemic inflammation in critically ill patients. The aim of this study is to investigate whether components of WBC counts can predict the prognosis of patients with cervical cancer. Methods: Medical records of 549 cervical cancer patients diagnosed between 1 January 2008 to 31 December 2008 were retrospectively analyzed. Receiver operating characteristic curve analysis and Cox proportional hazards model were applied to evaluate the effect of white blood cell (WBC) counts on overall survival. Results: The 5-year overall survival of the cohort was found to be 67.7%. On the basis of univariate analysis elevated monocyte count (≥0.515 10 9 /L) and lower lymphocyte count (≤2.075 10 9 /L) were associated with poor overall survival (OS) (p=0.016 and 0.002 respectively). Multivariate Cox proportional hazard analysis showed that higher monocyte and lower lymphocyte levels were a significant independent predictors for worse OS (HR = 1.555, 95% CI = 1.125-2.149; P=0.008) and (HR = 1.712, 95% CI = 1.232-2.379; P= 0.001) respectively. The advanced overall stage and treatment were also found to be independent indicators for poor OS. Conclusions: Pretreatment monocyte and lymphocyte count is an independent predictor of prognosis in cervical cancer patients. Thus it may be a cost effective marker to predict the outcome of cervical cancer patients.