Title: Patterns of Distant Failure in Carcinoma Cervix- A Regional Cancer Centre Experience
Authors: Dr Sanjukta Padhi, Meher Papuji, Sahoo Bijayalaxmi, Mohanty Sulagna
DOI: https://dx.doi.org/10.18535/jmscr/v4i10.52
Background: Cervical cancer is the most common malignancy among Indian females and is the leading cause of death. Patients with locally advanced cervical cancer after concurrent chemo radiation distant failure occur in many cases. Aim: To study the age distribution, clinical profile, sites, patterns, & duration of development distant failure in carcinoma cervix after completion of primary treatment. Materials: Retrospective study from the treatment records of patients of carcinoma cervix undergoing treatment at AHRCC. From January 2013 to June 2016, 91 patients of metastatic carcinoma cervix were selected & analysed retrospectively. Result: Majority of patients were from 5th and 6th decade followed by 7th decade. Most of them were in stage IIIB followed by stage II. Squamous cell histology was the most common entity. Commonly presented with non-regional nodal metastases out of which para-aortic lymph node metastases predominates. Following nodal metastases lungs was the second most site. Liver, bone and brain metastases were also seen. Most of the patients presented with metastasis within a period of 2 years from initial treatment time. Conclusion: Distant failure in carcinoma cervix depends upon the initial stage, age of presentation and histological findings. Though cervical carcinoma frequently spreads to the para-aortic nodes, lungs, liver and other uncommon sites are also reported. It necessitates a stringent follow up during period of first two years. Keywords: Carcinoma Cervix, Distant Metastasis. 1. Government of India - World Health Organization 2. Collaboration Programme 2004-2005. Guidelines for cervical cancer screening programme; 2006 2. Kawaguchi R < , Furukawa N , Kobayashi H , ET Al . PosttreatmentCutOFF Levels of squamous the Cell carcinoma Antigen AS A prognostic Factor in patients the with locally advanced cervical Cancer treated the with radiotherapy [J]. J GynecolOncol , 2013 , 24 ( 4 ) : 313 320 3. Kim the TE, Park BJ ,Kwack the HS , ET Al . Outcomes, and prognostic Factors of the After cervical Cancer Concurrent chemoradiation [J]. J ObstetGynaecol Res , 2012 , 38 ( . 11 ): 1315 1320 4. Kindermann J, Jabursch HP: The spread of squamous cell carcinoma of the uterine cervix into the blood vessels. Arch Gynoekol 212: 1, 1972 5. Thanagumtorn K. Survival rate of recurrent cervical carcinoma. J Med Assoc Thai. 2012 Mar;95Suppl 3:S125-130. 6. Ghaemmaghami F, Saleh-Gargari S, Sahebdel B, Behtash N, Samiei F. Risk factors and clinical aspects of recurrent invasive cervical carcinoma. J ObstetGynaecol India. 2012 Dec;62(6):674-678. doi: 10.1007/s13224-012-0227-8. Epub 2012 Sep 4. 7. Fagundes H , Perez CA, Grigsby PW, et al. D istant metastases after irradiation alone in carcinoma of the uterine cervix. Int J RadiatOncolBiolPhys 1992;24:197–204. 8. Blythe JG, Cohen MH, Buchsbaum HJ, Latourette HB. Bony metastases from carcinoma of cervix. Occurrence, diagnosis, and treatment. Cancer 1975;36:475‑84 9. Schmid MP, Franckena M, Kirchheiner K, Sturdza A, Georg P, Dörr W, Pötter R. Distant metastasis in patients with cervical cancer after primary radiotherapy with or without chemotherapy and image guided adaptive brachytherapy. GynecolOncol. 2014 May;133(2):256-62. doi: 10.1016/j.ygyno.2014.02.004. Epub 2014 Feb 8. PMID: 24517875 10. Van Nagell JR Jr, Rayburn W, Donaldson ES, Hanson M, Gay EC, Yoneda J, Marayuma Y, Powell DF. Therapeutic implications of patterns of recurrence in cancer of the uterine cervix. Cancer. 1979 Dec;44(6):2354-2361. 11. K. GeethaKumari, G. Sudhakar, M. Ramesh, V. L. Kalpana and G. Paddaiah. Prognostic Factors in Cervical Cancer: A Hospital-based Retrospective Study from Visakhapatnam City, Andhra Pradesh. J Life Sci, 2(2): 99-105 (2010). 12. Gadducci A, Tana R, Cosio S, Cionini L. Treatment options in recurrent cervical cancer (Review). Oncology Letters. 2010;1:3-11 13. Drescher CW, Hopkins MP, Roberts JA. Comparison of the pattern of metastatic spread of squamous cell cancer and adenocarcinoma of the uterine cervix. GynecolOncol 1989; 33:340-343. 14. Sotto LSJ, Graham JB, Pickren JW. Postmortem findings in cancer of the cervix. Am J ObstetGynecol 1960; 80:791-794.http://www.ajog.org/article/0002-9378(60)90591-3/abstract 15. Carlson V, Delclos L, Fletcher G. Distant metastases in squamous-cell carcinoma of the uterine cervix. Radiology 1967; 88:961-966. 16. Fyles A, Keane TJ, Barton M, et al. The effect of treatment duration in the local control of cervix cancer. RadiotherOncol 1992;25:273-279.Abstract
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