Ovarian, uterine, and cervical cancer patients with distant metastases at diagnosis: most common locations and outcomes

Gardner, A.B.; Charo, Lindsey; Mann, Amandeep; Kapp, Daniel S.; Eskander, Ramez N.; Chan, John K.

doi:10.1007/s10585-019-10007-0

Cited by 74 publications

(64 citation statements)

References 27 publications

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“…Metastatic cervical cancer remains a major cause of cancer related death in women. Lung is the most common metastatic organ, which accounts almost 50% of all metastasis [4,11]. We found in this study that the incidence of lung metastasis for cervical cancer was 4.33%, which is consistent with previous reports [6,8,12].…”

Section: Discussionsupporting

confidence: 92%

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Risk factors and prognostic predictors for Cervical Cancer patients with lung metastasis

Chen

Zhu

et al. 2020

J. Cancer

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Background: The most common metastatic site in cervical cancers is lung. The aim of this study is to identify cervical cancer patients with high risk for developing lung metastasis and further explore their prognosis. Materials and Methods: At first, patients diagnosed with cervical cancer from 2010 to 2015 were identified from The Surveillance, Epidemiology, and End Results (SEER) database. Multivariate logistic and Cox regression models were used to identify risk and prognostic factors in cervical cancer patients with lung metastasis. Besides, the clinical characteristics of 14 cervical cancer patients followed up for five years with only lung metastases treated at the First Affiliated Hospital of Wenzhou Medical University were retrospectively analyzed. Results: 19,377 cervical cancer patients were selected from the SEER database; the incidence of lung metastases is 4.33%. Multivariable analysis indicated that advantage age (p<0.001), non-squamous type (p<0.001), late stage (p<0.001), lymph nodes metastases (p<0.001), and poor differentiation (p<0.003) were associated with increased risks for developing lung metastasis. Survival analysis showed that adenocarcinoma, as well as bone and liver metastases were associated with shorter survival in multivariate Cox regression. Among 14 cervical cancer patients with only lung metastasis treated in our hospital, seven patients died within median follow-up time of 16.5 months, including six patients with multiple lung metastasis lesions and one patient with solitary lesion. Seven patients received pulmonary metastasectomy and the following cisplatin-based chemotherapy, among whom one patient died during follow up. Conclusions: Lung metastasis has poor prognosis. Senior age, non-squamous type, late stage, lymph nodes metastases, and poor differentiation are associated with an increased risk for lung metastasis. We recommend pulmonary imaging assessment within 2 years after primary treatment. Adenocarcinoma and multiple pulmonary lesions might predict poor prognosis. To those patients with resectable lung metastasis lesion and no other organ involvement, metastasectomy might improve survival.

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Section: Discussionsupporting

confidence: 92%

“…Pulmonary metastasis is the most common metastasis in cervical cancer 4 , 5 . Lung metastasis in cervical cancer is attributed to hematogenous spread.…”

Section: Introductionmentioning

confidence: 99%

Risk factors and prognostic predictors for Cervical Cancer patients with lung metastasis

Chen

Zhu

et al. 2020

J. Cancer

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“…To the best of our knowledge, the present study is the first to generate a risk model based on clinical and tumor characteristics through population-based surveillance, epidemiology, and final result databases to predict the risk of synchronous lung metastases in newly diagnosed ovarian cancer patients. We found that the higher the AJCC T and N stages, the higher the likelihood of metastases which is similar to likelihood of bone metastasis of ovarian cancer and the findings of other types of tumor metastases research [16][17][18]. Previous studies have shown that poor differentiation and lymph node involvement are risk factors for distant metastasis [4].…”

Section: Discussionsupporting

confidence: 79%

Development and validation of a nomogram to predict synchronous lung metastases in patients with ovarian cancer: a large cohort study

et al. 2020

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Purpose: Lung metastasis is an independent risk factor affecting the prognosis of ovarian cancer patients. We developed and validated a nomogram to predict the risk of synchronous lung metastases in newly diagnosed ovarian cancer patients. Methods: Data of ovarian cancer patients from the Surveillance, Epidemiology, and Final Results (SEER) database between 2010 and 2015 were retrospectively collected. The model nomogram was built on the basis of logistic regression. The consistency index (C-index) was used to evaluate the discernment of the synchronous lung metastasis nomogram. Calibration plots were drawn to analyze the consistency between the observed probability and predicted probability of synchronous lung metastases. The Kaplan–Meier method was used to estimate overall survival rate, and influencing factors were included in multivariate Cox regression analysis (P<0.05) to determine the independent prognostic factors of synchronous lung metastases. Results: Overall, 16059 eligible patients were randomly divided into training (n=11242) and validation cohorts (n=4817). AJCC T, N stage, bone metastases, brain metastases, and liver metastases were evaluated as predictors of synchronous lung metastases. Finally, a nomogram was constructed. The nomogram based on independent predictors was calibrated and showed good discriminative ability. Mixed histological types, chemotherapy, and primary site surgery were factors affecting the overall survival of patients with synchronous lung metastases. Conclusion: The clinical prediction model has high accuracy and can be used to predict lung metastasis risk in newly diagnosed ovarian cancer patients, which can guide the treatment of patients with synchronous lung metastases.

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“…The 5 year survival was 92, 75, 29%, respectively, for the localized cases, regional cases and distant cases ( 1 ). Studies of the patterns of distant metastases in stage IV ovarian cancer showed liver was the most common distant metastatic organ of ovarian cancer with the proportion of 37–57%, followed by distant lymph nodes, lung, bone and brain ( 3 – 5 ). Autopsy studies of cases died of primary ovarian cancer showed that the incidence of liver parenchyma was about 48.2–73% ( 5 , 6 ).…”

Section: Introductionmentioning

confidence: 99%

A Population-Based Study on Liver Metastases in Women With Newly Diagnosed Ovarian Cancer

Zhao

et al. 2020

Front. Oncol.

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The purpose of this study was to analyze the incidence, clinical characteristics, prognostic factors and survival of ovarian cancer patients with liver metastases upon initial diagnosis. Methods: Patients with ovarian cancer liver metastases upon initial diagnosis between 2010 and 2016 were identified from the Surveillance, Epidemiology, and End Results (SEER) database. Univariate and multivariate logistic regression was performed to identify the predictors of the presence of liver metastases in newly diagnosed ovarian cancer patients. Overall survival (OS) was assessed using the Kaplan-Meier method and logrank test. Univariate and multivariate Cox regression was conducted to determine the independent prognostic factors for OS. Results: A total of 1,744 ovarian cancer patients with liver metastases was identified from the SEER database, accounting for 6.7% of the entire ovarian cancer patients. As to the unique distant organ provided by SEER, liver was the most common metastatic site of ovarian cancer (4.65%). Age, race, laterality, histology, pathological grade, extrahepatic sites, stage of tumor were the predictors of the presence with liver metastases revealed by multivariable logistic regression model. Median OS for the patients with liver metastases at initial diagnosis of ovarian cancer was 16.0 months. Multivariate Cox regression model confirmed race, histology, extrahepatic metastatic sites, surgery and marital status were independent prognostic factors for OS. Conclusion: The study provided population-based estimates of the incidence and prognosis of newly diagnosed ovary cancer patients with liver metastases, which could be potentially used for the risk assessment and individualized treatment.

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Ovarian, uterine, and cervical cancer patients with distant metastases at diagnosis: most common locations and outcomes

Cited by 74 publications

References 27 publications

Risk factors and prognostic predictors for Cervical Cancer patients with lung metastasis

Risk factors and prognostic predictors for Cervical Cancer patients with lung metastasis

Development and validation of a nomogram to predict synchronous lung metastases in patients with ovarian cancer: a large cohort study

A Population-Based Study on Liver Metastases in Women With Newly Diagnosed Ovarian Cancer

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