Survival after Pelvic Exenteration for Cervical Cancer: A National Cancer Database Study

Stephen Graves, Brandon Luke L Seagle, Anna E. Strohl, Shohreh Shahabi, Wilberto Nieves-Neira

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Objective To determine overall survival (OS) and factors associated with OS after pelvic exenteration for cervical cancer. Methods Women with cervical cancer who underwent exenteration (n = 517) were identified from the 1998 to 2011 National Cancer Database. Kaplan-Meier and multivariate Cox proportional-hazards survival analyses were performed to test for associations of potential explanatory variables with OS. Analyzed confounders included age, insurance status, income, distance from home to treatment center, stage, exenteration type, surgical margin status, and treatment with adjuvant radiation and/or chemotherapy. Results Among the entire cohort with clinical follow-up (n = 313), median OS was 24 months. Stage (P = 2.5 × 10-12), lymph node status (P = 1.3 × 10-7), insurance status (P = 1.5 × 10-5), and histologic type (P = 0.04) were significantly associated with OS by the log-rank test. Unadjusted median OS was 24.2 and 61.8 months for women with squamous and adenocarcinoma histologies, respectively. By multivariate Cox regression, age, insurance status, stage, margin status, and adjuvant radiation were associated with OS. Histology was not independently associated with OS on multivariate regression. Among women with node-negative disease, median OS was 73.2 months. Conclusions Exenteration may be curative for more than half of women with node-negative cervical cancer. Stage, insurance status, lymph node status, and surgical margin are independently associated with differential OS after exenteration.

Original languageEnglish (US)
Pages (from-to)390-395
Number of pages6
JournalInternational Journal of Gynecological Cancer
Volume27
Issue number2
DOIs
StatePublished - Feb 1 2017
Externally publishedYes

Fingerprint

Pelvic Exenteration
Uterine Cervical Neoplasms
Databases
Survival
Insurance Coverage
Neoplasms
Histology
Lymph Nodes
Radiation
Survival Analysis
Adenocarcinoma

Keywords

  • Cervical cancer
  • Exenteration
  • Prognosis
  • Survival

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynecology

Cite this

Survival after Pelvic Exenteration for Cervical Cancer : A National Cancer Database Study. / Graves, Stephen; Seagle, Brandon Luke L; Strohl, Anna E.; Shahabi, Shohreh; Nieves-Neira, Wilberto.

In: International Journal of Gynecological Cancer, Vol. 27, No. 2, 01.02.2017, p. 390-395.

Research output: Contribution to journalArticle

Graves, Stephen ; Seagle, Brandon Luke L ; Strohl, Anna E. ; Shahabi, Shohreh ; Nieves-Neira, Wilberto. / Survival after Pelvic Exenteration for Cervical Cancer : A National Cancer Database Study. In: International Journal of Gynecological Cancer. 2017 ; Vol. 27, No. 2. pp. 390-395.
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abstract = "Objective To determine overall survival (OS) and factors associated with OS after pelvic exenteration for cervical cancer. Methods Women with cervical cancer who underwent exenteration (n = 517) were identified from the 1998 to 2011 National Cancer Database. Kaplan-Meier and multivariate Cox proportional-hazards survival analyses were performed to test for associations of potential explanatory variables with OS. Analyzed confounders included age, insurance status, income, distance from home to treatment center, stage, exenteration type, surgical margin status, and treatment with adjuvant radiation and/or chemotherapy. Results Among the entire cohort with clinical follow-up (n = 313), median OS was 24 months. Stage (P = 2.5 × 10-12), lymph node status (P = 1.3 × 10-7), insurance status (P = 1.5 × 10-5), and histologic type (P = 0.04) were significantly associated with OS by the log-rank test. Unadjusted median OS was 24.2 and 61.8 months for women with squamous and adenocarcinoma histologies, respectively. By multivariate Cox regression, age, insurance status, stage, margin status, and adjuvant radiation were associated with OS. Histology was not independently associated with OS on multivariate regression. Among women with node-negative disease, median OS was 73.2 months. Conclusions Exenteration may be curative for more than half of women with node-negative cervical cancer. Stage, insurance status, lymph node status, and surgical margin are independently associated with differential OS after exenteration.",
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N2 - Objective To determine overall survival (OS) and factors associated with OS after pelvic exenteration for cervical cancer. Methods Women with cervical cancer who underwent exenteration (n = 517) were identified from the 1998 to 2011 National Cancer Database. Kaplan-Meier and multivariate Cox proportional-hazards survival analyses were performed to test for associations of potential explanatory variables with OS. Analyzed confounders included age, insurance status, income, distance from home to treatment center, stage, exenteration type, surgical margin status, and treatment with adjuvant radiation and/or chemotherapy. Results Among the entire cohort with clinical follow-up (n = 313), median OS was 24 months. Stage (P = 2.5 × 10-12), lymph node status (P = 1.3 × 10-7), insurance status (P = 1.5 × 10-5), and histologic type (P = 0.04) were significantly associated with OS by the log-rank test. Unadjusted median OS was 24.2 and 61.8 months for women with squamous and adenocarcinoma histologies, respectively. By multivariate Cox regression, age, insurance status, stage, margin status, and adjuvant radiation were associated with OS. Histology was not independently associated with OS on multivariate regression. Among women with node-negative disease, median OS was 73.2 months. Conclusions Exenteration may be curative for more than half of women with node-negative cervical cancer. Stage, insurance status, lymph node status, and surgical margin are independently associated with differential OS after exenteration.

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