Prognostic Factors Influencing Overall Survival in Patients with Locally Advanced Cervical Cancer (LACC, FIGO Stage IIB-IVA) Treated with Concurrent Chemoradiotherapy
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Abstract
Background: Cervical cancer is a major concern in Thailand, with high prevalence and poor outcomes. Prognostic factors are diverse and complex.
Objectives: The purpose of this study is to investigate the prognostic factors that influence overall survival (OS) in LACC patients treated with concurrent chemoradiotherapy (CCRT).
Materials and methods: We conducted a retrospective cohort study involving 220 patients diagnosed with LACC patients treated with CCRT at Hatyai Hospital between 1 January 2014 and 31 December 2019. Overall survival rates at 1-yr, 3-yr, and 5-yr were analyzed, and the median survival time was estimated using the Kaplan-Meier method. The impact of various factors on OS was assessed using univariate and multivariate Cox proportional hazards models.
Results: The median follow-up time was 30.5 months. The 1-yr, 3-yr, and 5-yr OS were 74%, 46%, and 28%, respectively. The median OS was 17 months. Most patients had stage III 50.2% and squamous cell carcinoma 80.9%. After multivariate analysis, Body Mass Index (BMI) (p=0.03), stage III (p=0.001), stage IVA (p=0.036), neutrophil-to-lymphocyte ratio (NLR) (p=0.005) and platelet-to-lymphocyte ratio (PLR) (p=0.018) were significantly and independently associated with poorer OS.
Conclusion: A higher FIGO stage and elevated NLR and PLR values were associated with shorter survival. Conversely, maintaining an appropriate BMI emerged as a protective factor.
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