A Surgery-based Comprehensive Treatment Improved Prognosis in Patients with Stage IIIC Cervical Squamous Carcinoma: A Single Center Retrospective Study

Objective: This study intended to analyze the prognosis of patients with stage IIIC squamous cervical cancer who underwent the Obstetrics and Gynecology Hospital of Fudan University (FUOG) Treatment, and explored the factors influencing their prognosis. Design: A retrospective study. Setting: A large tertiary hospital specializing in obstetrics and gynecology in China. Population or Sample: This study collected data from 717 patients with stage IIIC squamous cervical cancer who underwent FUOG Treatment in our hospital from January 2016 to December 2020. Methods: Kaplan-Meier method was used to estimate progression-free survival (PFS) and overall survival (OS). Stratified analysis was performed to examine the risk factors. Main Outcome Measures: The main outcomes were 3-year PFS and OS. Results: The 3-year OS was 90.9% for patients with stage IIIC squamous cervical cancer, 91.5% for stage IIIC1 and 83.2% for stage IIIC2, respectively. The 3-year PFS was 84.8%, 85.3% for stage IIIC1 and 78.8% for stage IIIC2, respectively. Undifferentiated squamous carcinoma was an independent prognostic factor for OS (HR: 5.793, p=0.0064) and PFS (HR: 4.663, p=0.0033). Postoperative patients with standard adjuvant therapy had better 3-year OS outcomes than patients with non-standard therapy (88.4% vs 73.4%, p=0.007). Patients with undifferentiated type (OR=8.471), positive parietal infiltration (OR=3.339), or tumor infiltration depth of 1/3-2/3 (OR=5.454) were more likely to have distant recurrence. Conclusions: The prognosis of patients with stage IIIC cervical squamous carcinoma treated with the FUOG Treatment is satisfactory. However, risk factors such as undifferentiated type, positive paracervical infiltration, and non-standard adjuvant therapy can negatively affect prognosis.