Prognostic Factors of Advanced Cervical Cancer with Distant Metastasis

Purpose: Advanced cervical cancer with distant metastases is often difficult to treat and has an extremely poor prognosis. In this study, we aimed to examine treatment modalities that may contribute to prolonging overall survival. Methods: Under institutional review board approval, we conducted a retrospective study of 91 patients with advanced cervical cancer with distant metastasis who were treated at our hospital from 2000 to 2018. Overall survival was analyzed for each of the following prognostic factors: age, local stage, histological type, metastatic morphology (hematogenous metastasis or lymphadenopathy), presence or absence of local treatment with surgery or radiotherapy, and use of bevacizumab. Results: The median age was 58 years, and the median duration of observation was 34.5 months. The most common histological type was squamous cell carcinoma (64.8%). Eighty percent of patients opted for platinum-based chemotherapy as their first treatment. Univariate analysis detected histological type, metastatic morphology, presence or absence of local treatment with surgery or radiotherapy, and use of bevacizumab as significant prognostic factors, whereas multivariate analysis detected metastatic morphology, presence or absence of local treatment with surgery or radiotherapy, and use of bevacizumab as significant prognostic factors. Conclusion: In advanced cervical cancer, distant metastases can be controlled with chemotherapy, and the prognosis is relatively good when combined with local treatment. The results suggest that combined treatment strategies may contribute to prolonged survival and that bevacizumab use may extend survival.