Disease laterality independently predicts survival in stage IIIB cervical cancer in a prospective cohort study from...

Laterality of disease involvement in cervical cancer-unilateral versus bilateral parametrium and hydronephrosis-may carry prognostic implications in stage IIIB cervical cancer. Prospective Indian data addressing this issue remains limited. To evaluate the impact of unilateral and bilateral disease involvement on treatment response in women with locally advanced cervical cancer. This prospective, single-centre study (2022-2024) included 216 women with FIGO stage IIIB cervical cancer. Demographic, clinical, and radiological characteristics were collected. Disease laterality was assessed for the parametrium and hydronephrosis. Treatment response was evaluated using RECIST 1.1 criteria. Unilateral parametrium involvement predominated 162 (75%), with bilateral involvement in 54 (25%). Hydronephrosis was absent in 135 (65.3%), unilateral in 63 (27.8%), and bilateral in 18 (6.9%). Complete response (CR) was observed in 180 (83.34%) of patients. CR rates were 144 (88.8%) for unilateral and 36 (66%) for bilateral parametrium groups (p < 0.05). CR rates were seen in 120 (88.8%) for no hydronephrosis, 51 (81%) for unilateral hydronephrosis and 9 (50%) for bilateral hydronephrosis, respectively (p < 0.05). Bilateral hydronephrosis was associated with poorer response trends with CR - 9 (50%). Unilateral disease predominated, but bilateral hydronephrosis was associated with inferior outcomes. Disease laterality should be considered a relevant prognostic factor in advanced cervical cancer.