The concept of platinum sensitivity could be applied to recurrent cervical cancer: a multi-institutional retrospective study from the Japanese Gynecologic Oncology Group.

Abstract

This study aimed at evaluating the applicability of the concept of platinum sensitivity to recurrent cervical cancer. The clinical information of patients with recurrent cervical cancer, who were initially treated with platinum-based chemotherapy and received second-line platinum-based chemotherapy at the time of recurrence between January 2008 and December 2012, was retrospectively reviewed. A total of 677 patients from 71 medical centers were analyzed. The median overall survival (OS) for patients with platinum-free interval (PFI) of <6, 6-11, 12-17, and ≥18months was 12.1 (95% CI 11.0-14.1) months, 17.4 (15.5-20.4) months, 20.2 (17.9-27.6) months, and 29.9 (26.7-36.0) months, respectively (P<0.0001, log-rank). The best cut-off value of PFI that affected OS was 7months, analyzed by the minimum P value method. The median progression-free survival (PFS) for patients with less than and more than PFI of 7months was 6.2months (95% CI 4.8-9.3) and 21.0months (18.9-24.8) (P<0.0001, log-rank), respectively, and the median OS for patients with less than and more than PFI of 7months was 12.3months (11.2-14.1) and 24.2months (20.8-25.8) (P<0.0001, log-rank). Multivariate analysis revealed that PFI (P<0.0001, HR 0.449, 95% CI 0.369-0.548) alone had a statistically significant association with OS. This study showed that the concept of platinum sensitivity could be applied to recurrent cervical cancer and PFI could be one of the independent prognostic factors for patients with recurrent cervical cancer who have previously been treated with platinum-based chemotherapy.