999P - Modern outcomes of cervical carcinoma in Moroccan women treated with concurrent chemoradiotherapy

Date 29 September 2012
Event ESMO Congress 2012
Session Poster presentation I
Topics Anticancer agents
Cervical Cancer
Surgical oncology
Therapy
Biological therapy
Radiation oncology
Presenter Sanaa Elmajjaoui
Authors S. Elmajjaoui1, N. Ismaili2, K. Hassouni1, T. Kebdani1, N. Benjaafar1
  • 1Radiotherapy, NATIONAL INSTITUTE OF ONCOLOGY, 10000 - RABAT/MA
  • 2Medical Oncology, Hassan II Hospital Centre Régional d'Oncologie d'Agadir, 80000 - Agadir/MA

Abstract

Purpose

To report contemporary outcomes for nonmetastatic cervical cancer in Morrocan women treated in the modern area of concurrent chemoradiotherapy (CCRT).

Methods

we retrospectively reviewed the chart of 379 patients with nonmetastatic invasive cervical carcinoma treated with CCRT between January 2006 and December 2006. Staging was performed on a clinical basis according to the FIGO classification. Chemotherapy was based on weekly cisplatin (40mg /m2). Radiation treatment was based on external radiotherapy at a dose of 46 Gy followed by uterovaginal brachytherapy or additional radiotherapy at a dose of 24 Gy. Overall survival (OS), event-free survival (EFS) and locoregional recurrence free survival (LRRFS) were estimated by the Kaplan-Meier method. Treatment groups were compared by using log rank tests. Cox proportional hazard methods were used to determine prognostic factors for outcomes.

Results

Median age was 49 years (23-79 years). Bleeding was the main symptom (93.4%). Median tumor size was 7cm. About 3.7%, 28.5%, 1.3%, and 42.5% of the patients were stages IB2, IIBd, IIIA, and IIIB, respectively. The most predominant histological type was squamous cell carcinoma (96.4%). Median follow-up was 35 months (range 2-78 months). The rate of complete response was 93.9%. OS, EFS and LRRFS at 5 years were 76%, 56% and 82% respectively. On univariate analysis, we identified four prognostic factors: the stage, influencing OS, EFS and LRRFS (p < 0.001, p < 0.001 and p < 0.001, respectively); the tumor size, influencing OS and EFS (p = 0.034 and p = 0.019, respectively); the lymph node status (pelvic lymph node and/or para-aortic on imaging), influencing OS and EFS with trend to significance (p = 0.084 and p = 0.071, respectively). The anemia, influencing OS, EFS and LRRFS (p = 0.021, p = 0.027, and p = 0.087). On multivariate analysis, the stage was the only prognostic factor for OS (p = 0.002), EFS and LRRFS.

Conclusion

In Moroccan women with cervical carcinoma, CCRT is an efficient treatment which achieves a disease control in 93.9% of the cases. However, the prognosis remains relatively poor due to delayed diagnosis. On univariate analysis, prognostic factors were the stage, tumor size, lymph node involvement, and anemia. On multivariate analysis the stage was the only prognostic factor.

Disclosure

All authors have declared no conflicts of interest.