Significance of Malignant Peritoneal Cytology on the Survival of Women with Early-Stage Cervical Cancer: A Japanese Gynecologic Oncology Group Study

Journal of Clinical Medicine

Shoji Kamiura¹  Toru Sugiyama²  Takashi Iwata³  Yoshikazu Nagase⁴  Mikio Mikami⁵  Hiroko Machida⁵  Muneaki Shimada⁶  Shinya Matsuzaki⁷  Koji Matsuo⁷  Toshiaki Saito⁸ 

[1] Department of Gynecologic Oncology, Osaka International Cancer Institute, Osaka 541-8567, Japan;Department of Obstetrics and Gynecology, Iwate Medical University, Iwate 020-8505, Japan;Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo 160-8582, Japan;Department of Obstetrics and Gynecology, Osaka University, Osaka 565-0871, Japan;Department of Obstetrics and Gynecology, Tokai University, Kanagawa 259-1193, Japan;Department of Obstetrics and Gynecology, Tottori University, Tottori 683-8504, Japan;Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA 90033, USA;Gynecology Service, National Hospital Organization Kyushu Cancer Center, Fukuoka 811-1395, Japan;

关键词: cervical cancer;    radical hysterectomy;    peritoneal cytology: malignant cytology;    adjuvant therapy;    chemotherapy;    survival;   

DOI  :  10.3390/jcm8111822

来源: DOAJ

【 摘 要 】

This study examined the association between peritoneal cytology and survival in early-stage cervical cancer. This is a nationwide multicenter retrospective study, examining consecutive women with clinical stage IB1-IIB cervical cancer who underwent radical hysterectomy with available peritoneal cytology results from 2004−2008. Propensity score inverse probability of treatment weighting was used to assess the impact of malignant peritoneal cytology on survival. Among 1409 analyzed cases, 88 (6.2%) had malignant peritoneal cytology. On weighted models, malignant peritoneal cytology was associated with decreased disease-free survival (hazard ratio (HR) 1.78, 95% confidence interval (CI) 1.36−2.32) and overall survival (OS, HR 1.93, 95% CI 1.44−2.59). On sensitivity analyses, malignant peritoneal cytology was associated with decreased OS in adenocarcinoma/adenosquamous carcinoma, high-risk early-stage disease and those who received concurrent chemo-radiotherapy. However, among women who received postoperative systemic chemotherapy, malignant peritoneal cytology was not associated with OS (HR 1.21, 95% CI 0.72−2.04). A systematic review, including our results, showed that malignant peritoneal cytology was associated with decreased OS (HR 4.03, 95% CI 1.81−8.99) and increased recurrence in squamous carcinoma (odds ratio 1.89, 95% CI 1.05−3.39) and adenocarcinoma (odds ratio 4.30, 95% CI 2.30−8.02). In conclusion, the presence of malignant cells in peritoneal cytology is associated with decreased survival in early-stage cervical cancer. The possible benefit of systemic chemotherapy in this subgroup merits further investigation.

【 授权许可】

Unknown