Outcomes and patterns of management of metastatic/recurrent cervical carcinoma in Malaysia: A single institutional observational cohort study.
Cervical cancer is the fourth most common malignancy in women. Approximately 15% of the patients have metastatic disease. The Malaysian National Cancer Registry (MNCR) 2017-2021 reported that over the five-year period, there were 2654 new cases. 47.1% of the patients presented with late stages (stages 3 and 4), slightly higher compared to 41% in the MNCR 2012-2016 report. There were no standard approaches to the management of metastatic/recurrent cervical cancer. Therefore, this study aimed to determine the survival outcomes of patients with metastatic/recurrent cervical cancer and to evaluate the clinicopathological factors based on demographic and tumour characteristics that may affect survival outcomes. Besides that, we would like to outline the management patterns in this cohort of patients.
This was a retrospective observational cohort study looking at the 35 patients diagnosed with metastatic/recurrent cervical cancer at the Department of Clinical Oncology, Universiti Malaya Medical Centre (UMMC) over the five-year period from 1st of January 2016 until 31st of December 2020. Data were obtained from the electronic medical record. The Kruskal-Wallis H and Mann-Whitney U non-parametric tests, Spearman correlation, and Kaplan-Meier survival analysis were conducted to analyse the survival outcomes and clinicopathological factors that may affect the survival outcomes in the form of progression-free survival (PFS) and overall survival (OS). Descriptive analysis was used to describe the prevalence of metastatic/recurrent cervical cancer and the patterns of management.
Out of the total 94 cervical cancer patients registered at the Department of Clinical Oncology, UMMC, 37.2% had metastatic/recurrent disease. Survival analysis demonstrated that median PFS and OS for metastatic/recurrent cervical cancer were six and 12 months, respectively, which were consistent with the global populations. Nonparametric multivariate tests and survival analysis showed that the presence of metastatic disease at less common sites had worse survival. Most of the patients received active oncological treatments, i.e., chemotherapy, radiotherapy or combinations of both.
This study showed that a significant portion of the patients were diagnosed at a late stage, with poor survival outcomes, indicating the necessity for enhanced initiatives in the screening and education programmes to increase awareness of early diagnosis and detection, hence improving survival outcomes of cervical cancer patients.
This was a retrospective observational cohort study looking at the 35 patients diagnosed with metastatic/recurrent cervical cancer at the Department of Clinical Oncology, Universiti Malaya Medical Centre (UMMC) over the five-year period from 1st of January 2016 until 31st of December 2020. Data were obtained from the electronic medical record. The Kruskal-Wallis H and Mann-Whitney U non-parametric tests, Spearman correlation, and Kaplan-Meier survival analysis were conducted to analyse the survival outcomes and clinicopathological factors that may affect the survival outcomes in the form of progression-free survival (PFS) and overall survival (OS). Descriptive analysis was used to describe the prevalence of metastatic/recurrent cervical cancer and the patterns of management.
Out of the total 94 cervical cancer patients registered at the Department of Clinical Oncology, UMMC, 37.2% had metastatic/recurrent disease. Survival analysis demonstrated that median PFS and OS for metastatic/recurrent cervical cancer were six and 12 months, respectively, which were consistent with the global populations. Nonparametric multivariate tests and survival analysis showed that the presence of metastatic disease at less common sites had worse survival. Most of the patients received active oncological treatments, i.e., chemotherapy, radiotherapy or combinations of both.
This study showed that a significant portion of the patients were diagnosed at a late stage, with poor survival outcomes, indicating the necessity for enhanced initiatives in the screening and education programmes to increase awareness of early diagnosis and detection, hence improving survival outcomes of cervical cancer patients.