Metastasis patterns and survival analysis of 572 patients with metastatic cervical cancer: a hospital-based real world study

Jie SHEN; Xiaoshuang FENG; Hao WEN; Changming ZHOU; Miao MO; Zezhou WANG; Jing YUAN; Xiaohua WU; Ying ZHENG

doi:10.19401/j.cnki.1007-3639.2024.04.003

您当前的位置：

首页 >

文章列表页 >

Metastasis patterns and survival analysis of 572 patients with metastatic cervical cancer: a hospital-based real world study

Specialist' Article | 更新时间：2025-12-31

- Metastasis patterns and survival analysis of 572 patients with metastatic cervical cancer: a hospital-based real world study
- China Oncology Vol. 34, Issue 4, Pages: 361-367(2024)
- 作者机构：
  
  1. 复旦大学附属肿瘤医院肿瘤预防部，复旦大学上海医学院肿瘤学系，上海 200032
  2. 复旦大学附属肿瘤医院肿瘤妇科，复旦大学上海医学院肿瘤学系，上海 200032
- 作者简介：
- 基金信息：
  
  Three-year action plan for strengthening the construction of the public health system in Shanghai(GWVI-11.2-YQ37);Shanghai Shenkang Hospital Development Center City-Level Hospital Diagnosis and Treatment Technology Promotion and Optimization Management Project(SHDC22022308)
- DOI：10.19401/j.cnki.1007-3639.2024.04.003
  CLC： R737.33
- Received：28 December 2023，
  
  Revised：2024-02-19，
  
  Published：30 April 2024
- 稿件说明：
移动端阅览
Jie SHEN, Xiaoshuang FENG, Hao WEN, et al. Metastasis patterns and survival analysis of 572 patients with metastatic cervical cancer: a hospital-based real world study[J]. China Oncology, 2024, 34(4): 361-367.
DOI：

Jie SHEN, Xiaoshuang FENG, Hao WEN, et al. Metastasis patterns and survival analysis of 572 patients with metastatic cervical cancer: a hospital-based real world study[J]. China Oncology, 2024, 34(4): 361-367. DOI： 10.19401/j.cnki.1007-3639.2024.04.003.

摘要

背景与目的：

让宫颈癌患者获得有效的治疗是全球消除宫颈癌的策略之一。本文通过分析以医院登记为基础的宫

颈癌发生远处转移患者的转移特征及转移后生存情况，为改善宫颈癌患者的生存情况并最终消除宫颈癌提供真实世界的科学证据。

方法：

基于复旦大学附属肿瘤医院2008—2017年确诊并接受治疗的宫颈癌患者，纳入初诊时已发生远处转移或者随访过程中发生远处转移的宫颈癌患者共572例，通过患者复诊病史资料、电话随访及死因数据链接等方式收集生存信息。研究起始时间为转移发生时间，随访统计时间截至2020年11月1日。应用Kaplan-Meier法绘制总体及不同转移部位的生存曲线，并估计不同转移部位的中位生存时间及1、3和5年总生存（overall survival，OS）率。

结果：

随访中位时间为38.93个月，期间共发生全死因死亡348例。72.55%为单一部位转移，27.45%为多发性转移。在所有转移部位中，肺转移比例最高（41.26%），其次为骨转移（15.21%），肝转移占11.54%，位列第3位。发生转移后，1、3和5年的OS率分别为62.29%（95% CI：62.25 ~ 62.33）、33.13%（95% CI：33.08 ~ 33.18）和23.42%（95% CI：23.37 ~ 23.47）。单一部位转移中，转移至肺后的1年OS率最高（72.52%），3和5年各个部位转移后的OS差异不显著。

结论：

宫颈癌最易发生远处转移的部位依次为肺、骨和肝，远处转移发生后患者的生存情况较差，规范和完善远处转移后的诊疗体系，可望改善患者的生存情况。

Abstract

Background and purpose:

Effective treatment for cervical cancer patients is one of the global strategies to eliminate cervical cancer. By analyzing the metastasis characteristics and survival status of patients with distant metastasis of cervical cancer from a hospital-based cancer registry data

our study provided real-world evidence for better survival of cervical cancer and finally eliminating cervical cancer.

Methods:

A total of 572 cervical cancer patients who had metastasis cancer at the initial diagnosis or developed distant metastasis during follow-up in Fudan University Shanghai Cancer Center from 2008 to 2017 were included in this study. Medical records review

telephone visits and death registry data linkage were applied in collecting endpoint data. The first follow-up date was the diagnose date of metastasis

and the last follow-up date was November 1

2020. Kaplan-Meier method was applied in evaluating the 1-

3- and 5-year overall survival (OS) rates for overall and site-specific patients.

Results:

The median follow-up time was 38.93 months

and 348 cases died during the follow-up. 72.55% were single site metastasis

and 27.45% were multiple metastases. Among all metastatic sites

the proportion of lung metastasis was the hi

ghest

41.26%

15.21% to bone

and 11.54% to liver. After metastasis

the 1-year

3-year and 5-year OS rates were 62.29% (95% CI: 62.25-62.33)

33.13% (95% CI: 33.08-33.18) and 23.42% (95% CI: 23.37-23.47)

respectively. In single site metastasis

1-year OS was the highest after metastasis to the lung (72.52%). Besides

there was no significant difference among different metastatic sites

both in 3-year and 5-year OS.

Conclusion:

The most frequent distant metastatic sites of cervical cancer are lung

bone and liver. The survival rate after metastasis is poor. Further research with systematic treatment strategy is required for better survival.

关键词

Keywords

references

GULTEKIN M , RAMIREZ P T , BROUTET N , et al . World Health Organization call for action to eliminate cervical cancer globally [J ] . Int J Gynecol Cancer , 2020 , 30 ( 4 ): 426 - 427 . DOI: 10.1136/ijgc-2020-001285 http://doi.org/10.1136/ijgc-2020-001285

BRAY F , FERLAY J , SOERJOMATARAM I , et al . Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries [J ] . CA Cancer J Clin , 2018 , 68 ( 6 ): 394 - 424 .

SIEGEL R L , MILLER K D , JEMAL A . Cancer statistics, 2016 [J ] . CA A Cancer J Clin , 2016 , 66 ( 1 ): 7 - 30 .

YIN Z M , TANG H R , LI L , et al . Impact of sites versus number of metastases on survival of patients with organ metastasis from newly diagnosed cervical cancer [J ] . Cancer Manag Res , 2019 , 11 : 7759 - 7766 . DOI: 10.2147/CMAR.S203037 http://doi.org/10.2147/CMAR.S203037

SASANO T , MABUCHI S , KURODA H , et al . Predictors of survival in patients with FIGO stage ⅣB cervical cancer [J ] . Int J Gynecol Cancer , 2016 , 26 ( 3 ): 528 - 533 .

KIM K , CHO S Y , KIM B J , et al . The type of metastasis is a prognostic factor in disseminated cervical cancer [J ] . J Gynecol Oncol , 2010 , 21 ( 3 ): 186 - 190 . DOI: 10.3802/jgo.2010.21.3.186 http://doi.org/10.3802/jgo.2010.21.3.186

ZHANG Y R , GUO Y , ZHOU X Z , et al . Prognosis for different patterns of distant metastases in patients with uterine cervical cancer: a population-based analysis [J ] . J Cancer , 2020 , 11 ( 6 ): 1532 - 1541 . DOI: 10.7150/jca.37390 http://doi.org/10.7150/jca.37390

CHEN X Y , CHEN L , ZHU H Y , et al . Risk factors and prognostic predictors for cervical cancer patients with lung metastasis [J ] . J Cancer , 2020 , 11 ( 20 ): 5880 - 5889 . DOI: 10.7150/jca.46258 http://doi.org/10.7150/jca.46258

ZHANG Y R , GUO X , WANG G W , et al . Real-world study of the incidence, risk factors, and prognostic factors associated with bone metastases in women with uterine cervical cancer using surveillance, epidemiology, and end results (SEER) data analysis [J ] . Med Sci Monit , 2018 , 24 : 6387 - 6397 .

郑莹 . 上海市肿瘤预防控制工作70年回顾 [J ] . 中国卫生资源 , 2019 , 22 ( 4 ): 269 - 273 .

ZHENG Y . Seventy years of cancer prevention and control in Shanghai [J ] . Chin Health Resour , 2019 , 22 ( 4 ): 269 - 273 .

周昌明 , 莫淼 , 袁晶 , 等 . 以医院登记为基础的20万例恶性肿瘤患者生存报告 [J ] . 中国癌症杂志 , 2020 , 30 ( 1 ): 11 - 24 .

ZHOU C M , MO M , YUAN J , et al . Report on 200 thousand cancer patients' survival from a hospital-based cancer registry database [J ] . China Oncol , 2020 , 30 ( 1 ): 11 - 24 .

冯小双 , 周昌明 , 莫淼 , 等 . 以大型单中心医院登记为基础的2万例癌症转移患者的转移特征及生存分析 [J ] . 中国癌症杂志 , 2021 , 31 ( 1 ): 11 - 19 .

FENG X S , ZHOU C M , MO M , et al . Metastasis patterns and survival analysis of 20 000 patients with metastasis from a hospital-based cancer registry database [J ] . China Oncol , 2021 , 31 ( 1 ): 11 - 19 .

CARLSON V , DELCLOS L , FLETCHER G H . Distant metastases in squamous-cell carcinoma of the uterine cervix [J ] . Radiology , 1967 , 88 ( 5 ): 961 - 966 . DOI: 10.1148/88.5.961 http://doi.org/10.1148/88.5.961

BIELSKA-LASOTA M , ROSSI S , KRZYŻAK M , et al . Reasons for low cervical cancer survival in new accession European Union countries: a EUROCARE-5 study [J ] . Arch Gynecol Obstet , 2020 , 301 ( 2 ): 591 - 602 .

ABU-RUSTUM N R , YASHAR C M , AREND R , et al . NCCN clinical practice guidelines in oncology: cervical cancer. Version 1.2023 [EB/OL ] . [2023-12-27 ] . https://www.nccn.org. https://www.nccn.org https://www.nccn.org

ABU-RUSTUM N R . Management of recurrent or metastatic cervical cancer [J ] . J Natl Compr Cancer Netw , 2023 , 21 ( 5 ): 576 - 578 .

COHEN P A , JHINGRAN A , OAKNIN A , et al . Cervical cancer [J ] . Lancet , 2019 , 393 ( 10167 ): 169 - 182 . DOI: S0140-6736(18)32470-X http://doi.org/S0140-6736(18)32470-X

TEWARI K S , SILL M W , PENSON R T , et al . Bevacizumab for advanced cervical cancer: final overall survival and adverse event analysis of a randomised, controlled, open-label, phase 3 trial (Gynecologic Oncology Group 240) [J ] . Lancet , 2017 , 390 ( 10103 ): 1654 - 1663 . DOI: S0140-6736(17)31607-0 http://doi.org/S0140-6736(17)31607-0

HELLMAN S , WEICHSELBAUM R R . Oligometastases [J ] . J Clin Oncol , 1995 , 13 ( 1 ): 8 - 10 . DOI: 10.1200/JCO.1995.13.1.8 http://doi.org/10.1200/JCO.1995.13.1.8

NING M S , AHOBILA V , JHINGRAN A , et al . Outcomes and patterns of relapse after definitive radiation therapy for oligometastatic cervical cancer [J ] . Gynecol Oncol , 2018 , 148 ( 1 ): 132 - 138 . DOI: S0090-8258(17)31420-8 http://doi.org/S0090-8258(17)31420-8

HOU X R , WANG W P , ZHANG F Q , et al . Stereotactic body radiation therapy for oligometastatic pulmonary tumors from cervical cancer [J ] . Asia Pac J Clin Oncol , 2019 , 15 ( 5 ): e175 - e180 .

Views

2055

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Metastasis patterns and survival analysis of 20 000 patients with metastasis from a hospital-based cancer registry database

Effectiveness and safety analysis of camrelizumab combined with chemotherapy and targeted therapy in patients with recurrent, metastatic, and treatment-naive advanced cervical cancer: a retrospective cohort study

Report on 200 thousand cancer patients’ survival from a hospital-based cancer registry database

Treatment strategies and prognostic analysis of 87 patients with salivary duct carcinoma: a retrospective cohort study

Research progress and prospects on the mechanisms of circulating tumor cells in the invasion and metastasis of cholangiocarcinoma

Related Author

冯小双

周昌明

莫　淼

袁　晶

沈　洁

王泽洲

张志红

秦一雨

Related Institution

复旦大学附属肿瘤医院肿瘤预防部，复旦大学上海医学院肿瘤学系

上海众访信息技术有限公司

复旦大学附属肿瘤医院乳腺外科，复旦大学上海医学院肿瘤学系

复旦大学附属肿瘤医院肿瘤放疗科，复旦大学上海医学院肿瘤学系

Department of Surgical Oncology, Minhang Branch, Fudan University Shanghai Cancer Center

AI问答

⁰