Treatment and prognosis of bone metastasis from cervical cancer (KCOG-G1202s)

Abstract

Aim: The early and precise diagnosis and proper palliative treatment of bone metastasis is important for improving the quality of life of cervical cancer patients. The aim of this study was to clarify the clinical features, treatment modalities and prognosis of bone metastasis in cervical cancer patients in Japan.

Methods: The medical records of 75 cervical cancer patients with bone metastasis who were treated between January 2000 and December 2010 were retrospectively analyzed in a multi-institutional study.

Results: Fifty-four patients (72.0%) had a single bone metastasis. Bone metastases were found in the spine (46.7%) and pelvis (42.7%). Forty-three patients (57.3%) also had extra-osseous metastases. Most of the patients received radiotherapy, chemotherapy or both, but 25 patients (33.3%) received palliative care only. Bisphosphonates were given as palliative therapy to 25 patients (33.3%). The median overall survival after the diagnosis of bone metastasis was significantly shorter in patients with extra-osseous metastases than in those without extra-osseous metastases (14 vs 5 months; P < 0.05). The survival of patients who received chemotherapy following radiotherapy or concurrent chemoradiotherapy was significantly longer than that of the patients who received palliative care. On multivariate analysis, the presence of extra-osseous metastasis was an independent predictor of survival in patients with bone metastasis from cervical cancer.

Conclusions: Multidisciplinary treatment might improve the prognosis of patients with bone metastasis who do not have extra-osseous lesions.

Keywords: bisphosphonates; bone metastasis; cervical cancer.