Abstract 784P
Background
The purpose of this study was to determine the patient, disease, and treatment characteristics of stage IB-IV cervical cancer associated with differences in recurrence and survival.
Methods
This is a retrospective chart review of cervical cancer patients in BC between January 1, 2010 and December 31, 2017. We collected demographic data, treatment details and covariates of prognostic significance. Data was analyzed using logistic regression, multivariate Cox regressions, and 2-tailed t tests.
Results
780 patients were examined (stage I 31.5%, II 20.0%, III 34.5%, IV 3.3%). Survival outcomes are presented in the table. Decreased survival was associated with lymphovascular invasion and p16 negativity. Increased survival was associated with surgical resection, radical radiotherapy (RT), brachytherapy and concurrent cisplatin chemotherapy. 5 weeks of chemotherapy improved outcomes (vs. <5 weeks) but dose reduction did not significantly reduce survival. Peri-RT chemotherapy was not associated with survival benefit in adeno/adenosquamous carcinoma. 180 women recurred (23.1%) with mostly distant metastases (42.8%). We saw lower incidence of recurrence after primary surgical resection in those with tumor size <2cm vs. tumors >2cm (4.1% vs 24.7%, p=0.0004). Though only 37.7% of recurrence/metastases was treated with first-line carboplatin/paclitaxel/bevacizumab, it was associated with better overall survival compared to carboplatin/paclitaxel (median OS 22.59 vs. 12.16 months, p=0.00038). Table: 784P
Disease and treatment characteristics and their effect on median overall survival
| Characteristic | Median Overall Survival (months) | P Value | |
| Lymphovascular Invasion | Yes No Unknown | NA NA 95.1 | <0.0001 |
| P16 | Positive Negative Unknown | NA 17.2 NA | <0.0001 |
| Surgical Resection | Yes No | NA 124 | p<0.0001 |
| Radical Radiotherapy | Yes No | NA 21.6 | p<0.0001 |
| Type of RT | EBRT + Brachytherapy EBRT alone | 29.2 NA | <0.0001 |
| Concurrent Chemotherapy | Yes No | NA 44.6 | <0.0001 |
| Type of concurrent chemotherapy | Cisplatin Other | NA 26.8 | <0.0001 |
| Weeks of concurrent chemotherapy | 5 weeks <5 weeks | NA NA | <0.0001 |
| Chemotherapy Dose Reduction | Yes No | NA NA | 0.18 |
| Peri-RT chemotherapy in adeno/adenosquamous | Yes No | NA NA | 0.11 |
Conclusions
Lymphovascular invasion is associated with decreased median overall survival, and p16 negative women have worse survival compared to p16 positive or unknown. We saw lower incidence of recurrence after primary surgical resection if initial tumor was <2cm. First-line carboplatin/paclitaxel/bevacizumab for recurrence shows improves survival but only a small proportion of women received it.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
J.J. Ko: Financial Interests, Institutional, Research Grant: Janssen; Financial Interests, Institutional, Research Grant: Bayer; Financial Interests, Personal, Other, Honorarium: Janssen; Financial Interests, Personal, Other, Honorarium: Astellas; Financial Interests, Personal, Other, Honorarium: Bayer; Financial Interests, Personal, Other, Honorarium: Merck; Financial Interests, Personal, Other, Honorarium: BMS; Financial Interests, Personal, Other, Honorarium: Roche. All other authors have declared no conflicts of interest.