Clinical analysis and prognostic factors in 106 patients with stage Ia-IIb cervical cancer with pulmonary metastasis

Abstract

To investigate the clinical characteristics and prognostic factors for patients with stage Ia-IIb cervical cancer with pulmonary metastasis (CCMP). Clinical information of 106 patients with stage Ia-IIb cervical cancer with lung metastases admitted in the Chinese Academy of Medical Sciences Cancer Hospital from January 1999 to June 2013 was collected. The efficacy of different therapeutic methods for lung metastases was compared and relevant prognostic factors were analyzed. Pulmonary metastases were detected in 89 (83.9%) out of a total of 106 patients within 2 years after initial treatment of cervical cancer. The median disease-free interval (DFI) of the 106 patients was 13 months. The median survival after CCMP was 18 months, with 2-year and 5-year survival rates of 37.7% and 7.5%, respectively. Metastases were mainly distributed in the inferior lobe of right lung. The surgical treatment was proven to be clinically effective in both unilateral and bilateral CCMP. The response rate was 60.2% in patients choosing non-operative treatment. The univariate analysis showed that pathological type of cervix carcinoma, low degree of differentiation, scope of pulmonary metastasis and whether CCMP simultaneously accompanied with other parts of recurrence were closely related to the prognosis, while the differentiation of cervical tumor was an independent prognostic factor drawn from multivariate regression analysis. Regular CT lung screening is recommended for patients with stage Ia-IIb cervical cancer during their follow-up period. Both operative and non-operative treatments are feasible therapeutic methods for CCMP. But surgical resection is strictly restricted to certain operative indications. Ia-IIb stage cervical cancer of low differentiation has poorer prognosis after lung metastasis.