Oncologic Outcomes of Stage IVB or Persistent or Recurrent Cervical Carcinoma Patients Treated With Chemotherapy at Siriraj Hospital: Thailand’s Largest Tertiary Referral Center

Ruengkhachorn, Irene; Leelaphatanadit, Chairat; Therasakvichya, Suwanit; Hunnangkul, Saowalak

doi:10.1097/igc.0000000000000712

Cited by 4 publications

(6 citation statements)

References 19 publications

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“…Reported PFS times and OS times ranged from 5.6 to 6.9 months and 11.6 to 18.3 months, respectively. Japanese and Thai studies showed favorable oncologic outcomes compared to outcomes reported in several Gynecologic Oncology Group (GOG) studies [4, 6, 14–17]. Individual host-related factors might be major prognostic indicators related to survival, including BMI, performance status, distant metastasis, and systemic inflammatory response.…”

Section: Discussionmentioning

confidence: 99%

“…Our previous clinical study revealed satisfactory results from this treatment strategy, with an overall response rate of 37.8%. In that study, the lone independent clinical predictor of shorter OS was distant metastatic disease, while BMI ≥25 kg/m 2 and non-squamous cell carcinoma were found to be independent predictors of longer PFS [17]. Previous studies reported a range of response rates and survival times, with an overall response rate that varied from 22.3 to 62.6%.…”

Section: Discussionmentioning

confidence: 99%

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Neutrophil-lymphocyte ratio as a predictor of oncologic outcomes in stage IVB, persistent, or recurrent cervical cancer patients treated by chemotherapy

Ittiamornlert¹,

Ruengkhachorn²

2019

BMC Cancer

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BackgroundCervical cancer patients with stage IVB, persistent, or recurrent disease after complete primary treatment are usually treated with systemic chemotherapy. Circulating blood components have been a target of study relative to their ability to predict cancer outcomes; however, no previous study has focused on patients with advanced, persistent, or recurrent cervical carcinoma who were treated by chemotherapy, which adversely affects hematopoietic and immune activity. The predictive value of complete blood cell differential counts in patients with stage IVB, persistent, or recurrent cervical cancer treated by chemotherapy, may be able to triage these patients.MethodsThis retrospective chart review was conducted in cervical cancer patients with stage IVB disease, persistent disease, or recurrent disease who were treated by chemotherapy during January 2006 to January 2017 were reviewed. Follow-up data were collected through July 2017.ResultsA total of 355 cervical carcinoma patients were included. Of those, 63 patients received chemotherapy as primary treatment, and 292 patients received chemotherapy for persistent or recurrent disease. Mean age was 52.5 ± 10.3 years, median age was 51.9 years (IQR: 45.0–59.7), and mean BMI was 23.3 ± 4.9 kg/m2. Overall response rate was 37.5%, with a median progression free survival (PFS) of 5.7 months, and with a median overall survival (OS) of 38.1 months. Multivariate analysis revealed elevated platelet count (> 400,000/mm3), squamous cell carcinoma subtype, and distant metastasis to be associated with poorer PFS. Elevated neutrophil count (> 7000/mm3), elevated platelet count (> 400,000/mm3), squamous cell carcinoma subtype, and distant metastasis were found to be associated with poorer OS. Neutrophil-lymphocyte ratio ≥ 3.6 was the most valuable predictor of poor oncologic outcome relative to overall response rate (odds ratio = 1.642, 95% confidence interval [CI]: 1.048–2.572, P = 0.030), PFS (hazard ratio [HR] = 1.676, 95% CI: 1.334–2.107, P < 0.001), and OS (HR = 2.544, 95% CI: 1.672–3.870, P < 0.001).ConclusionsNeutrophil-lymphocyte ratio ≥ 3.6 was identified as an independent predictor of poor oncologic outcome relative to overall response rate, PFS and OS.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Neutrophil-lymphocyte ratio as a predictor of oncologic outcomes in stage IVB, persistent, or recurrent cervical cancer patients treated by chemotherapy

Ittiamornlert¹,

Ruengkhachorn²

2019

BMC Cancer

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“…Until now, many studies related to mCC have contained patients with both synchronous and recurrent metastatic diseases. 7 , 13–15 But the reality is they have completely different treatment patterns that may affect the prognosis of patients. 16 , 17 …”

Section: Introductionmentioning

confidence: 99%

“…Until now, many studies related to mCC have contained patients with both synchronous and recurrent metastatic diseases. 7,[13][14][15] But the reality is they have completely different treatment patterns that may affect the prognosis of patients. 16,17 Therefore, this retrospective study aimed to explore the risk factors associated with the prognosis of newly diagnosis mCC patients and to construct nomograms to facilitate clinical practice.…”

Section: Introductionmentioning

confidence: 99%

Dynamic Nomogram Based on the Metastatic Number and Sites and Therapy Strategies Predicting the Prognosis of Patients with Metastatic Cervical Cancer

Tan

et al. 2022

IJWH

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Background Individual survival prediction is of vital importance to optimize the individualized treatment of metastatic cervical cancer (mCC) patients. The goal of this study was to identify the potential risk factors for the survival of mCC patients and construct a nomogram for their prognosis. Methods Medical records of patients with newly diagnosed mCC at the First Affiliated Hospital of Xi’an Jiaotong University were reviewed retrospectively. Risk factors were identified using Cox proportional hazards analysis and Kaplan–Meier curves. Random forest was used to identify factors associated with therapy strategy. Nomogram and dynamic nomogram were established using ‘rms’ and “DynNom” R package. Results A total of 98 patients with mCC were finally identified. In Cox analyses, multiple metastases and concurrent chemoradiotherapy (CCRT) were identified as independent predictors for overall survival (OS). We further explored the prognostic value of metastatic number and sites and therapy strategies for mCC patients by Kaplan–Meier curves. A dynamic nomogram including metastases number and sites (multiple metastases, liver and lymph node (LN) above diaphragm metastases) and chemoradiotherapy strategies (CCRT, postradiotherapy chemotherapy, and radiotherapy to metastatic sites) was constructed for predicting the prognosis of mCC patients. For newly diagnosed patients, we strongly recommended the combination of chemotherapy and definitive pelvic radiotherapy and, if possible, radiation to metastatic site, but CCRT should be implemented with caution. We constructed a dynamic nomogram indicating that patients with younger age, shorter symptom duration, and better laboratory test results are suitable for CCRT. Conclusion Survival analyses showed that the metastatic number and sites and therapy strategies are associated with the prognosis of mCC patients. The CCRT and prognostic nomograms may help clinicians to make better clinical decisions and effectively predict the prognosis for newly diagnosed mCC patients.

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“…Also, in resource-limited settings, the use of oral metronomic chemotherapy (OMC) has been described [14]. The overall response rates (ORR) from 15% to 65% have been described for various protocols in various settings of care [15][16][17][18][19][20][21][22][23][24]. There is paucity of data regarding the outcomes of systemic treatment of recurrent cervical cancer from India [20].…”

Section: Introductionmentioning

confidence: 99%

Recurrent cervical cancer treated with palliative chemotherapy: real-world outcome

Mailankody¹,

Dhanushkodi²,

Ganesan³

et al. 2020

ecancer

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Introduction: Cervical cancer is the third most common cancer in India. There is limited data on the treatment of relapsed cervical cancer from India; therefore, we report the outcomes of patients with recurrent cervical cancer who were treated with palliative chemotherapy (CT). Materials and methods: This was a retrospective study of patients with recurrent cervical cancer who received palliative CT from January 2012 to December 2016. The demographic details, clinical profile and survival outcomes were collected. Patients were treated with carboplatin or paclitaxel and carboplatin. Local radiation was given for symptomatic patients. Patients were assessed for responses clinically and/or radiologically after three and six cycles of CT. Progression-free survival (PFS) and overall survival (OS) were calculated using the Kaplan-Meier method. Results: Forty-six patients with recurrent cervical cancer were included in this analysis, with a median follow-up of 9.4 months. The median age was 49.5 (25-65) years and the median disease-free interval was 31.3 (2-196) months. Biopsy confirmation of relapse was established in 63%. The median number of CT cycles was six. Twenty-four (52.2%) patients completed six cycles of CT. The overall response rate was 56.5%. Patients with a complete or a partial response were more likely to have PFS > 6 months (p < 0.0001). Median PFS and OS were, respectively, 8.4 (95% CI 6.1-10.7) months and 10.3 (95% CI 6.8-13.8) months. The completion of all cycles of CT and the site of metastasis (nodal vs. visceral or combined) were found to be associated with OS. Conclusion: Palliative CT with paclitaxel carboplatin is a safe and effective option in Indian patients with recurrent cervical cancer, with more than half of the patients completing the prescribed CT. Further prospective trials may be required to place this treatment in the right context, in this era of immunotherapy and targeted therapy. However, knowing the outcomes in our population and prognostic factors will help in better prognostication of patients, thereby channelling our limited resources where necessary.

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Oncologic Outcomes of Stage IVB or Persistent or Recurrent Cervical Carcinoma Patients Treated With Chemotherapy at Siriraj Hospital: Thailand’s Largest Tertiary Referral Center

Cited by 4 publications

References 19 publications

Neutrophil-lymphocyte ratio as a predictor of oncologic outcomes in stage IVB, persistent, or recurrent cervical cancer patients treated by chemotherapy

Neutrophil-lymphocyte ratio as a predictor of oncologic outcomes in stage IVB, persistent, or recurrent cervical cancer patients treated by chemotherapy

Dynamic Nomogram Based on the Metastatic Number and Sites and Therapy Strategies Predicting the Prognosis of Patients with Metastatic Cervical Cancer

Recurrent cervical cancer treated with palliative chemotherapy: real-world outcome

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