Abstract
BackgroundCervical cancer continues to be one of the leading causes of cancer deaths among females in low and middle-income countries. In this study, we aimed to assess the independent prognostic value of clinical and potential prognostic factors in progression-free survival (PFS) in cervical cancer.MethodsWe conducted a retrospective study on 92 cervical cancer patients treated from 2017 to 2019 at the Zhuhai Hospital of Traditional Chinese and Western Medicine. Tumor characteristics, treatment options, progression-free survival and follow-up information were collected. Kaplan–Meier method was used to assess the PFS.ResultsResults showed that the number of retrieved lymph nodes had a statistically significant effect on PFS of cervical cancer patients (P = 0.002). Kaplan-Meier survival curve analysis showed that cervical cancer patients with initial symptoms age 25–39 had worse survival prognoses (P = 0.020). And the using of uterine manipulator in laparoscopic treatment showed a better prognosis (P < 0.001). A novel discovery of our study was to verify the prognostic values of retrieved lymph nodes count combining with FIGO staging system, which had never been investigated in cervical cancer before. According to the Kaplan-Meier survival curve analysis and receiver operating characteristic (ROC) curve analysis, significant improvements were found after the combination of retrieved lymph nodes count and FIGO stage in predicting PFS for cervical cancer patients (P < 0.001, AUC = 0.826, 95% CI: 0.689–0.962).ConclusionNumber of retrieved lymph nodes, initial symptoms age, uterine manipulator, and retrieved lymph nodes count combining with FIGO staging system could be potential prognostic factors for cervical cancer patients.
Highlights
Cervical cancer continues to be one of the leading causes of cancer deaths among females in low and middle-income countries
Prognostic significance of factors By generating Kaplan-Meier curves of progression-free survival (PFS), we found that the initial symptom age 25–39 group had significantly worse PFS (P = 0.020) compared to the initial symptom age 40–75 group (Fig. 1 a)
The AUC of retrieved lymph nodes count combined with International Federation of Gynecology and Obstetrics (FIGO) stage (AUC = 0.826, 95% CI: 0.689–0.962) was better than FIGO staging alone (AUC = 0.748, 95% CI: 0.561–0.935) in prognostic prediction for cervical cancer patients. These results indicated that the combination of retrieved lymph nodes count (31–85 and 16–30 or 86–105) and FIGO staging classification could act as a potential predictor for prognosis of cervical cancer patients
Summary
Cervical cancer continues to be one of the leading causes of cancer deaths among females in low and middle-income countries. In low and middle-income countries (LMICs), cervical cancer continues to be the second most prevalent cancers in morbidity and one of the leading causes of cancer deaths among females [2, 3]. It is a remarkable cause of mortality and morbidity among youthful and middle-aged women aged 20 to 39 years all over the world [4]. Due to the lack of valid prevention and screening methods, it is worth noting that morbidity of cervical cancer is still increasing in less-developed countries in recent years [5, 6] It appears to be an important step to find out potential prognostic factors in progression-free survival for patients with cervical cancer
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