Pattern of distant metastases in treated cases of carcinoma cervix : An analysis

Abstract

Aims: To analyze pattern of distant failure, site of metastases, number of metastases and duration in patient with carcinoma of cervix treated with concomitant chemoradiation. Materials and Methods: From May 2011 to December 2015, 73 patients of carcinoma cervix who treated with radical treatment (concomitant chemoradiation followed by 3 session of HDR brachytherapy) with distant metastases presented at Department of Radiotherapy-II, Pt BDS PGIMS, Rohtak were evaluated retrospectively. Results: Most of the female with metastases were in age group of 50-59 years (82%), 12% were in age group >60 and 6% were in < 50 year age group. Initial stage of presentation was 40% (29/73), 48% (35/73) and 12% (9/73) in stage II, III and IVA respectively. Out of which 93% had squamous cell carcinoma histology and 7% were having adenocarcinoma at time of presentation. Among them 49/73 (67%) had solitary metastases, 19/73 (26%) had two metastatic sites and 5/73 (7%) had multiple metastatic sites. Commonest site of distant metastases was paraaortic lymphnodes in 40% of cases, followed by liver, lungs, brains, cervical lymph nodes and one case of cutaneous metastases was also seen. Paraaortic lymphnodes, liver and lung metastases present in maximum number of patient with multiple metastases. Salvage chemotherapy given in 51 cases, palliative radiotherapy (30 Gy or 20 Gy) in 37 cases whereas in 5% of cases single session with 8 Gy was given. Conclusion: A regular and long term follow up of patients with carcinoma of cervix is necessary to detect distant metastases. With early and proper diagnosis and treatment a better outcome could be achieved.