Comparison of survival outcomes of locally advanced cervical cancer by histopathological types in the Surveillance, Epidemiology, and End Results (SEER) database: A propensity score matching study

Abstract Background: There has been limited research on the comparison of squamous cell carcinoma (SCC) and adenocarcinoma (AC) of cervical cancer and that lack of information may have significant bearing on the treatment of patients. We compared survival outcomes between squamous cell carcinoma and adenocarcinoma in locally advanced cervical cancer patients and examined factors related to the prognosis of cervical cancer.Methods: We identified 4,131 patients with stage IB2-ⅣA cervical cancer patients diagnosed between 2010 and 2015 by using the Surveillance, Epidemiology, and End Results (SEER) database. Variables related to the prognosis of cervical cancer were compared using both univariate and multivariate Cox models and log-rank method before and after propensity score matching. We compared the efficacy of radiotherapy alone to radiotherapy combined with chemotherapy or/and surgery in overall survival of SCC and AC. Results: Our sample included 3,385 patients with SCC (81.9%) and 746 patients with AC (18.1%). The 5-year overall survival on comparing the squamous cell carcinoma group and adenocarcinoma group was not significant (P>0.05). Using propensity score matching, 676 pairs of patients were selected. The 5-year overall survival of matched patients did not differ significantly (P>0.05). Histology was not independently associated with overall survival in multivariate Cox model (P>0.05). Factors affecting overall survival included FIGO stage IVA (P<0.05), chemotherapy (P<0.05), and external radiation combined with brachytherapy (P<0.05). Patients with SCC that were treated with radiation alone had significantly worse OS than AC patients receiving radiation only (P<0.05). Conclusions: The OS in AC of the cervix is similar to that SCC in when treated with radiotherapy combined with chemotherapy and/or surgery but better when treated with radiation alone.

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Comparison of survival outcomes of locally advanced cervical cancer by histopathological types in the Surveillance, Epidemiology, and End Results (SEER) database: A propensity score matching study

10.21203/rs.3.rs-18088/v1 ◽

2020 ◽

Author(s):

Tian Tian ◽

Xing Gong ◽

Dong Xu Gao ◽

Qing Yan Li ◽

Wen Ju ◽

...

Keyword(s):

Cervical Cancer ◽

Overall Survival ◽

Squamous Cell Carcinoma ◽

Propensity Score ◽

Cell Carcinoma ◽

Propensity Score Matching ◽

Squamous Cell ◽

Locally Advanced ◽

Seer Database ◽

Locally Advanced Cervical Cancer

Abstract Background: There has been limited research on the comparison of squamous cell carcinoma (SCC) and adenocarcinoma (AC) of cervical cancer and that lack of information may have significant bearing on the treatment of patients. We compared survival outcomes between squamous cell carcinoma and adenocarcinoma in locally advanced cervical cancer patients and examined factors related to the prognosis of cervical cancer. Methods: We identified 4,061 patients with stage IB2-ⅣA cervical cancer patients diagnosed between 2010 and 2015 by using the Surveillance, Epidemiology, and End Results (SEER) database. Variables related to the prognosis of cervical cancer were compared using both univariate and multivariate Cox models and log-rank method before and after propensity score matching. We compared the efficacy of radiotherapy alone to radiotherapy combined with chemotherapy or/and surgery in overall survival of SCC and AC.Results: Our sample included 3,385 patients with SCC (83.4%) and 676 patients with AC (16.6%). The 5-year overall survival on comparing the squamous cell carcinoma group and adenocarcinoma group was not significant (P>0.05). Using propensity score matching, 676 pairs of patients were selected. The 5-year overall survival of matched patients did not differ significantly (P>0.05). Histology was not independently associated with overall survival in multivariate Cox model (P>0.05). Factors affecting overall survival included FIGO stage IVA (P<0.05), chemotherapy (P<0.05), and external radiation combined with brachytherapy (P<0.05). Patients with SCC that were treated with radiation alone had significantly worse OS than AC patients receiving radiation only (P<0.05). Conclusions : The OS in AC of the cervix is similar to that in when treated with radiotherapy combined with chemotherapy and/or surgery but better when treated with radiation alone.

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A study of prognostic factors in patients with locally advanced cervical cancer treated with radiotherapy: Establishing post-treatment cut-off levels for tumor marker squamous cell carcinoma antigen.

Journal of Clinical Oncology ◽

10.1200/jco.2011.29.15_suppl.e15571 ◽

2011 ◽

Vol 29 (15_suppl) ◽

pp. e15571-e15571

Author(s):

R. Kawaguchi ◽

N. Furukawa ◽

H. Kobayashi

Keyword(s):

Cervical Cancer ◽

Squamous Cell Carcinoma ◽

Prognostic Factors ◽

Tumor Marker ◽

Cell Carcinoma ◽

Squamous Cell ◽

Locally Advanced ◽

Advanced Cervical Cancer ◽

Squamous Cell Carcinoma Antigen ◽

Locally Advanced Cervical Cancer

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The impact of radiotherapy, in addition to chemotherapy, on overall survival in the initial management of patients with newly diagnosed metastatic head and neck squamous cell carcinoma.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.6035 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. 6035-6035

Author(s):

Sujith Baliga ◽

Rafi Kabarriti ◽

Nitin Ohri ◽

Chandan Guha ◽

Shalom Kalnicki ◽

...

Keyword(s):

Overall Survival ◽

Squamous Cell Carcinoma ◽

Radiation Therapy ◽

Propensity Score ◽

Cell Carcinoma ◽

Head And Neck ◽

Propensity Score Matching ◽

Squamous Cell ◽

Prolonged Survival ◽

Newly Diagnosed

6035 Background: The role of radiation therapy (RT) in the upfront management of patients with metastatic head and neck squamous cell carcinoma (HNSCC) is not clearly defined. In this study, we used the National Cancer Database (NCDB) to assess the association between RT use and overall survival (OS) for patients with metastatic HNSCC who received chemotherapy. Methods: We analyzed the NCDB to identify patients with newly diagnosed metastatic HNSCC from 2004-2013 who were treated with upfront chemotherapy. Associations between the use of RT and OS were evaluated using the Kaplan Meier method, univariate and multivariate cox regression, propensity score matching, and sequential landmark analysis. Survival outcomes were also compared for patients receiving a biologically effective dose (BED) ≥72 Gy10 and < 72 Gy10. Results: We identified 3,516 patients diagnosed with metastatic HNSCC who were treated with chemotherapy, of which 2,288 (65%) were also treated with RT. The median follow up was 11.9 months. The addition of RT to chemotherapy was associated with prolonged survival (median 13.6 v 11.3 months, logrank p < 0.001). On multivariate analysis, the use of RT remained associated with prolonged survival (HR = 0.71, 95% CI 0.61-0.82, p < 0.001). After propensity score matching, the addition of RT was associated with improved median survival (13.5 v 11.2 months) and 5-year (17% v 7%) OS compared to chemotherapy alone (log rank, p < 0·001). Landmark analyses limited to patients who survived at least 3, 6, and 12 months after diagnosis continued to demonstrate improved OS with the addition of RT. Among patients treated with RT, the use of RT schedules with a BED exceeding 72 Gy10 was associated with prolonged survival (median 18.0 versus 11.7 months, logrank p < 0.001). Conclusions: For patients with metastatic HNSCC, the addition of RT to chemotherapy was associated with improved OS in this population based study. These results provide rationale for prospective randomized trials to validate these findings and to determine the optimal radiation therapy dose/fractionation and treatment schedule for these patients.

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