Epidemiological and Survival Trends in Patients of Cancer of Uterine Cervix Treated with Definitive Concurrent Chemoradiotherapy: Observations from a North Indian Hospital-Based Cancer Registry

  • Nishant Lohia
  • Manoj PrasharEmail author
  • Sankalp Singh
  • Sharad Bhatnagar
  • S. Viswanath
  • S. Anand
  • Richa Ranjan
Original Article



Worldwide, cervical cancer is the fourth most common cancer in women and a significant proportion of this cancer comes from India. Identifying various prognostic factors on survival outcomes will help us in giving better care and thereby prolonging life of these patients. Objective of this study was to assess various factors and their association with outcomes in terms of overall survival (OS) and disease-free survival (DFS) at 2 years and 5 years.


This was a retrospective study carried out in a tertiary cancer care hospital. The data of 86 patients treated between November 2013 and November 2016 were retrospectively analyzed for OS and DFS using Kaplan–Meier survival curves. Association of various demographic and disease variables with OS and DFS was analyzed using Chi-square test.


Among 86 patients included in the study, 84 (97.7%) were still alive at completed follow-up of 24 months and 77 (89.5%) were disease-free. At 5-year follow-up for 41 patients, 23 (56.1%) were alive and 21 (51.2%) were disease-free. Presence of pelvic lymphadenopathy and a hemoglobin of less than 10 mg/dl before or during treatment negatively impacted OS and DFS.


OS and DFS rates in our practice are comparable to those in the published literature. Multiple treatment and disease variables can effect treatment outcomes and disease prognosis.


Cervical cancer Overall survival Prognostic factors 


Compliance with Ethical Standards

Conflict of interest

The authors declared that they have no conflict of interest.


  1. 1.
    Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394–424.CrossRefGoogle Scholar
  2. 2.
    Ferlay J, Soerjomataram I, Ervik M, Dikshit R, Eser S, Mathers C, et al. Cancer incidence and mortality worldwide: IARC cancer base no. 11. Lyon: International Agency for Research on Cancer; 2013.Google Scholar
  3. 3.
    Denny L. Cervical cancer treatment in Africa. Curr Opin Oncol. 2011;23(5):469–74.CrossRefGoogle Scholar
  4. 4.
    Tripathi N, Kadam YR, Dhobale RV, Gore AD. Barriers for early detection of cancer amongst Indian rural women. South Asian J Cancer. 2014;3:122–7.CrossRefGoogle Scholar
  5. 5.
    Pramesh CS, Badwe RA, Borthakur BB, Chandra M, et al. Current burden and health systems in India 3-delivery of affordable and equitable cancer care in India. Lancet Oncol. 2014. Scholar
  6. 6.
    Viswanathan AN. Uterine cervix in Perez and Brady’s principles and practice of radiation oncology. 3rd ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2013. pp. 1355–425.Google Scholar
  7. 7.
    Bhatla N, Berek J, Cuello M, et al. New revised FIGO staging of cervical cancer (2018). Abstract S020.2. Presented at the FIGO XXII World Congress of Gynecology and Obstetrics. Rio de Janeiro, Brazil, October 14–19, 2018. Int J Gynecol Obstet 2018;143 Suppl 3.
  8. 8.
    Picorelli S. Revised FIGO staging for carcinoma of the vulva, cervix and endometrium. FIGO Committee on Gynecologic Oncology. Int J Gynaecol Obstet. 2009;105(2):103–4.CrossRefGoogle Scholar
  9. 9.
    Thulaseedharan JV, Malila N, Hakama M, et al. Socio demographic and reproductive risk factors for cervical cancer: a large prospective cohort study from rural India. Asian Pac J Cancer Prev. 2012;13(6):2991–5.CrossRefGoogle Scholar
  10. 10.
    Delaloye JF, Pampallona S, Coucke PA, et al. Younger age as a bad prognostic factor in patients with carcinoma of the cervix. Eur J Obstet Gynecol Reprod Biol. 1996;64:201–5.CrossRefGoogle Scholar
  11. 11.
    Dattoli MJ, Gretz HF, Beller U, et al. Analysis of multiple prognostic factors in patients with stage IB cervical cancer: age as a major determinant. Int J Radiat Oncol Biol Phys. 1989;17:41–7.CrossRefGoogle Scholar
  12. 12.
    Meanwell CA, Kelly KA, Wilson S, et al. Young age as a prognostic factor in cervical cancer: analysis of population based data from 10,022 cases. Br Med J (Clin Res Ed). 1988;296:386–91.CrossRefGoogle Scholar
  13. 13.
    Reagan JW, Fu YS. Histologic types and prognosis of cancers of the uterine cervix. Int J Radiat Oncol Biol Phys. 1979;5:1015–20.CrossRefGoogle Scholar
  14. 14.
    Crissman JD, Budhraja M, Aron BS, et al. Histopathologic prognostic factors in stage II and III squamous cell carcinoma of the uterine cervix: an evaluation of 91 patients treated primarily with radiation therapy. Int J Gynecol Pathol. 1987;6:97–103.CrossRefGoogle Scholar
  15. 15.
    Monk BJ, Wang J, Im S, et al. Rethinking the use of radiation and chemotherapy after radical hysterectomy: a clinical-pathologic analysis of a Gynecologic Oncology Group/Southwest Oncology Group/Radiation Therapy Oncology Group trial. Gynecol Oncol. 2005;96:721–8.CrossRefGoogle Scholar
  16. 16.
    Berman ML, Keys H, Creasman W, et al. Survival and patterns of Recurrence in cervical cancer metastatic to periaortic lymph nodes (a Gynecologic Oncology Group study). Gynecol Oncol. 1984;19:8–16.CrossRefGoogle Scholar
  17. 17.
    Delgado G, Bundy BN, Fowler WC Jr, et al. A prospective surgical Pathological study of stage I squamous carcinoma of the cervix: a Gynecologic Oncology Group Study. Gynecol Oncol. 1989;35:314–20.CrossRefGoogle Scholar
  18. 18.
    Lagasse LD, Creasman WT, Shingleton HM, et al. Results and complications of operative staging in cervical cancer: experience of the Gynecologic Oncology Group. Gynecol Oncol. 1980;9:90–8.CrossRefGoogle Scholar
  19. 19.
    Lee YN, Wang KL, Lin MH, et al. Radical hysterectomy with pelvic lymph node dissection for treatment of cervical cancer: a clinical review of 954 cases. Gynecol Oncol. 1989;32:135–42.CrossRefGoogle Scholar
  20. 20.
    Bishop AJ, Allen PK, Klopp AH, et al. Relationship between low hemoglobin levels and outcomes after treatment with radiation or chemoradiation in patients with cervical cancer: has the impact of anemia been overstated? Int J Radiat Oncol Biol Phys. 2015;91(1):196–205.CrossRefGoogle Scholar
  21. 21.
    Withers HR, Taylor JM, Maciejewski B. The hazard of accelerated tumor clonogen repopulation during radiotherapy. Acta Oncol. 1988;27:131–46.CrossRefGoogle Scholar

Copyright information

© Association of Gynecologic Oncologists of India 2019

Authors and Affiliations

  • Nishant Lohia
    • 1
  • Manoj Prashar
    • 1
    Email author
  • Sankalp Singh
    • 1
  • Sharad Bhatnagar
    • 1
  • S. Viswanath
    • 1
  • S. Anand
    • 1
  • Richa Ranjan
    • 1
  1. 1.Command Hospital (CC)LucknowIndia

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