Differences of characteristics, influencing factors, and treatment effects on the survival in patients with first and second primary cervical cancer

To explore the characteristics, influencing factors, and effect of different treatments on the survival in patients with first primary cervical cancer (CC) and second primary CC. Data of 33,934 eligible patients with CC were extracted from the Surveillance, Epidemiology, and End Results (SEER) database in 2004-2015. We also included 176 patients with CC from the Affiliated Dongyang Hospital of Wenzhou Medical University. Univariate and multivariate Cox proportional hazard models were used to screen the potential influencing factors associated with the survival in patients with hazard ratios (HRs) and 95 % confidence intervals (CIs). Subgroup analyses of age, American Joint Committee on Cancer (AJCC) stages, tumor grades and histologic types were conducted to explore the association between different treatments and survival in different populations. The 5-year mortality was 43.08 % for patients with first primary CC and that was 58.13 % for patients with second primary CC. We found that the relationships between age, histologic type, tumor grade, tumor size, AJCC tumor-node-metastasis (TNM) stage, surgery, chemotherapy, radiotherapy and the first primary CC and second primary CC were different (all P < 0.05). Additionally, the results of subgroup analyses indicated that the choice of surgery, chemotherapy, and radiotherapy should be adjusted according to the different health conditions of the patients. In conclusion, the causal relationship between characteristics, influencing factors, and treatments and survival in patients with primary CC diagnosed as different time periods are needed further exploration.