A retrospective analysis of prognostic factors in patients with cervical non-squamous cell carcinoma treated with concurrent chemoradiotherapy

Objective: To investigate the prognostic factors for cervical non-squamous cell carcinoma (NSCC) patients who were treated with concurrent chemoradiotherapy (CCRT). Methods: We retrospectively analyzed the clinical records of 111 cervical NSCC patients who were treated with CCRT at Peking Union Medical College Hospital between January 2005 and December 2014. Survival data were analyzed by Kaplan-Meier method. Univariate analysis of prognostic factors for overall survival was performed by Wilcoxon (Gehan) test. Prognostic factors for overall survival and progression free survival (PFS) were further analyzed by multivariate Cox regression model. Results: Of the 111 patients, 83 (74.8%) had adenocarcinoma, 16 (14.4%) had adenosquamous carcinoma, and 12 (10.8%) had other special types. According to FIGO staging system, 9 (8.1%) had stage I, 8 (7.2%) had stage IIA. 75 (67.6%) had stage IIB, and 19 (17.1%) had stage III/IV. Fifty-five patients had tumor diameter < 4 cm. Forty-three patients (38.8%) had positive pre-treatment CA125. Fifty-five patients (49.5%) had pelvic lymph node enlargement. The 5-year overall survival rate was 66.0%. Univariant and multivariant analysis identified FIGO stage, local tumor size, histological grade, lymph node enlargement as prognostic factors for overall survival. FIGO stage and tumor size were independently assocaited with the progrssion-free survival of these patients. Conclusion: FIGO stage, local tumor size, histological grade, lymph node enlargement are prognostic factors for cervical NSCC. Patients with higher FIGO stage and/or tumor diameter >= 4 cm have poor posnosis and early tumor progression following CCRT. New treatment strategies should be considered for these patients.