Objectives: Cervical cancer is the second most common malignancy among Indian women after breast cancer. This study was undertaken to determine the pattern of care, long-term survival outcomes, and prognostic factors for cervical cancer patients treated at a tertiary care cancer centre in North India.
Methods: Ten-year data was retrieved for 435 stage I-IVA carcinoma cervix patients treated between 2009 and 2019. A sociodemographic profile of the patients, treatment methods, and conditions at follow-up were obtained.
Statistical analysis: Data was analyzed using Stata 15.1 (StataCorp LLC, College Station, Texas, United States). Qualitative variables were shown as frequencies/percentages, and quantitative as means/standard deviations. Key endpoints were overall, disease-free, and locoregional survival. Kaplan-Meier curves represented survival. Cox regression models assessed parameter influence. Statistical significance was set at p < 0.05, with hazard ratios and 95% confidence intervals reported.
Results: Fourteen (3.2%) patients underwent surgery; of the patients who underwent surgery, except two patients who underwent surgery alone, all patients received external beam radiotherapy (EBRT) followed by EBRT (26.4%) or brachytherapy boost (72.4%). Seventy-one per cent of patients received more than four cycles of concurrent chemotherapy. The median overall survival (OS) was 42.04 (0.25-171) months, and the median disease-free survival (DFS) was 32.85 months (1-171) months. The median overall survival was 58.76%, and the two-year and five-year overall survival percentages were 81.34% and 64.52%, respectively. The median time to locoregional relapse and distant metastasis was 35 (1-171) and 37.6 (1-171) months, respectively. Bilateral parametrial involvement was a predictor of poor OS (p = 0.039), DFS (p = 0.039), and locoregional failure-free survival (LFFS) (p = 0.020). Age less than 50 years was a predictor of worse DFS (p = 0.034) and LFFS (p = 0.005), while paraaortic nodal involvement was a predictor of worse DFS (p = 0.045). Grade III tumours neared numerical significance (p = 0.051) for worse distant metastases-free survival.
Conclusion: Bilateral parametrial involvement was the most significant factor for OS, DFS, and LFFS. Paraaortic nodal involvement predicted poor DFS and young age was associated with poor DFS and LFFS.
