Smokers with cervix cancer have more uterine corpus invasive disease and an increased risk of recurrence after treatment with chemoradiation

Mileshkin, Linda, Paramanathan, Ashvin, Kondalsamy-Chennakesavan, Srinivas, Bernshaw, David, Khaw, Pearly and Narayan, Kailash (2014) Smokers with cervix cancer have more uterine corpus invasive disease and an increased risk of recurrence after treatment with chemoradiation. International Journal of Gynecological Cancer, 24 7: 1286-1291. doi:10.1097/IGC.0000000000000170


Author Mileshkin, Linda
Paramanathan, Ashvin
Kondalsamy-Chennakesavan, Srinivas
Bernshaw, David
Khaw, Pearly
Narayan, Kailash
Title Smokers with cervix cancer have more uterine corpus invasive disease and an increased risk of recurrence after treatment with chemoradiation
Journal name International Journal of Gynecological Cancer   Check publisher's open access policy
ISSN 1525-1438
1048-891X
Publication date 2014-09-01
Year available 2014
Sub-type Article (original research)
DOI 10.1097/IGC.0000000000000170
Volume 24
Issue 7
Start page 1286
End page 1291
Total pages 6
Place of publication New York, NY, United States
Publisher Lippincott Williams & Wilkins
Collection year 2015
Language eng
Formatted abstract
Background: Smoking is a risk factor for cervix cancer and causes hypoxemia, which promotes tumor infiltration and potentially impacts on treatment outcome. We performed a retrospective study to determine if smokers had an increased risk of uterine corpus infiltration, which is associated with more advanced disease and/or treatment failure after primary chemoradiation.

Methods: Results from a prospective database of patients treated with primary chemoradiation for locally advanced cervix cancer with a pretreatment MRI were analyzed. Smoking status was assessed by self-report at presentation.

Results: Smoking status was recorded for 346 of the 362 patients with 98 current smokers (28%), 56 ex-smokers (16%), and 192 nonsmokers (55%). Median age was 58 years with ever-smokers having a younger age at diagnosis than nonsmokers. Histologic type, International Federation of Gynecology and Obstetrics stage, tumor volume, and nodal involvement were similar across groups, as were toxicities of treatment. Ever-smokers were more likely to have corpus uterine invasion than nonsmokers. Ever-smokers had more recurrences than nonsmokers, with nonsmokers having a longer median overall survival (50.1 vs 38.7 months, P = 0.004) and relapse-free survival (46.8 vs 28.5 months, P = 0.003). In multifactor analysis, ever-smoking status was a significant predictor of developing corpus invasive disease and of inferior relapse-free and overall survival after treatment.

Conclusions: Smokers have a greater risk for developing corpus invasive cervix cancer. Although nonsmokers have an older age at diagnosis, they live longer and have fewer recurrences after a diagnosis of locally advanced carcinoma of the cervix.
Keyword Cervix cancer
Smoking
Chemoradiation
Outcomes
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2015 Collection
School of Medicine Publications
 
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