Background: Concurrent chemoradiation therapy (CCRT) is the standard treatment for patients with locally advanced cervical cancer (LACC), including those with parametrial or lymphatic metastasis. However, therapeutic outcomes vary, and prognostic factors remain inadequately defined. Methods: We conducted a retrospective study involving 128 patients with cervical cancer who received definitive CCRT between 2003 and 2022 at Seoul National University Bundang Hospital. We evaluated clinicopathological variables, including age, height, body weight, histologic type, tumor size, human papillomavirus (HPV) type, squamous cell carcinoma (SCC) antigen levels, and involvement of the parametrium, lower vagina, and lymph nodes. Survival outcomes were analyzed using Kaplan–Meier curves and Cox proportional hazards models. Results: Stage IIIC1r, according to the 2018 FIGO staging system, was the most common disease stage among the study population. Para-aortic lymph node metastasis was significantly associated with increased recurrence risk (odds ratio [OR] = 5.892; 95% confidence interval [CI]: 2.030–17.097;p= 0.001) and was linked to poorer progression-free survival (PFS,p= 0.001), overall survival (OS,p= 0.014), and treatment-free interval (TFI,p= 0.001). Obesity (body mass index ≥ 25 kg/m2) was also associated with higher recurrence risk (OR = 2.737; 95% CI: 1.093–6.855;p= 0.032) and reduced PFS (p= 0.0089). Conclusions: Para-aortic lymph node metastasis and obesity are significant prognostic factors in patients undergoing definitive CCRT for LACC. These findings highlight the need for risk-adapted treatment strategies and potential incorporation of adjunctive therapies to improve clinical outcomes in high-risk patient subgroups.
背景：同步放化疗（CCRT）是局部晚期宫颈癌（LACC）患者的标准治疗方案，包括伴有宫旁或淋巴结转移的患者。然而，治疗效果存在差异，且预后因素尚未得到充分界定。 方法：我们开展了一项回顾性研究，纳入了2003年至2022年间在首尔国立大学盆唐医院接受根治性CCRT的128例宫颈癌患者。我们评估了临床病理学变量，包括年龄、身高、体重、组织学类型、肿瘤大小、人乳头瘤病毒（HPV）类型、鳞状细胞癌（SCC）抗原水平，以及宫旁、阴道下段和淋巴结的受累情况。使用Kaplan-Meier曲线和Cox比例风险模型分析生存结局。 结果：根据2018年FIGO分期系统，IIIC1r期是研究人群中最常见的疾病分期。腹主动脉旁淋巴结转移与复发风险增加显著相关（比值比[OR] = 5.892；95%置信区间[CI]：2.030–17.097；p=0.001），并与较差的无进展生存期（PFS，p=0.001）、总生存期（OS，p=0.014）和无治疗间期（TFI，p=0.001）相关。肥胖（体重指数≥25 kg/m²）也与较高的复发风险（OR = 2.737；95% CI：1.093–6.855；p=0.032）和降低的PFS（p=0.0089）相关。 结论：腹主动脉旁淋巴结转移和肥胖是LACC患者接受根治性CCRT的重要预后因素。这些发现强调了需要制定风险适应性治疗策略，并可能纳入辅助治疗，以改善高危患者亚组的临床结局。
肿瘤(癌症)患者之家