Adjuvant therapy in early-stage cervical cancer after radical hysterectomy: are we overtreating our patients? A meta-analysis.

Autor: Gómez-Hidalgo NR; Unit of Gynecologic Oncology, Service of Gynecology, Vall d'Hebron Barcelona Hospital Campus, Autonoma University of Barcelona, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain. nrodriguez.gh@gmail.com., Acosta Ú; Unit of Gynecologic Oncology, Service of Gynecology, Vall d'Hebron Barcelona Hospital Campus, Autonoma University of Barcelona, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain., Rodríguez TG; Gynecology Department, Virgen de la Victoria University Hospital, Málaga, Spain., Mico S; Radiotherapy Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain., Verges R; Radiotherapy Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain., Conesa VB; Unit of Gynecologic Oncology, Service of Gynecology, Vall d'Hebron Barcelona Hospital Campus, Autonoma University of Barcelona, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain., Bradbury M; Unit of Gynecologic Oncology, Service of Gynecology, Vall d'Hebron Barcelona Hospital Campus, Autonoma University of Barcelona, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain., Pérez-Hoyos S; Statistics Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain., Pérez-Benavente A; Unit of Gynecologic Oncology, Service of Gynecology, Vall d'Hebron Barcelona Hospital Campus, Autonoma University of Barcelona, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain., Gil-Moreno A; Unit of Gynecologic Oncology, Service of Gynecology, Vall d'Hebron Barcelona Hospital Campus, Autonoma University of Barcelona, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain.; Centro de Investigación Biomédica en Red de Cáncer, CIBERONC, Madrid, Spain.
Jazyk: angličtina
Zdroj: Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico [Clin Transl Oncol] 2022 Aug; Vol. 24 (8), pp. 1605-1614. Date of Electronic Publication: 2022 Apr 19.
DOI: 10.1007/s12094-022-02808-9
Abstrakt: Objective: There is a gap in knowledge regarding the ideal management of patients with early-stage cervical cancer and intermediate-risk features. Here, we present a meta-analysis of the published literature on oncological outcomes in these patients and determine trends in postoperative management.
Methods: MEDLINE and PubMed were used for literature searches. The inclusion criteria were: English language articles including ≥ 10 patients, patients who underwent radical hysterectomy, nodes negative, studies reporting oncological outcomes and complications treatment-related and compare a surgery-only cohort with a radiotherapy cohort. The PRISMA guidelines were followed. Combined relative risk was calculated using DerSimonian-Laird random-effects model and a forest plot was drawn.
Results: We collected 183 manuscripts on early-stage cervical cancer treated with radical hysterectomy alone or with adjuvant radiotherapy after surgery. A total of eight studies met the inclusion criteria. Regarding oncological outcomes, survival was reported in five studies. The relative risk of recurrence and the relative risk of mortality was similar in both groups independently whether receive or not adjuvant therapy. Most of the studies did not report significant differences regarding morbidity treatment related between the groups, except for a higher rate of lymphedema after radiotherapy.
Conclusion: We found that the relative risk of recurrence and mortality was similar in both groups not depending on adjuvant therapy. Therefore, whether radiotherapy adjuvant treatment is indicated remains a topic of debate.
(© 2022. The Author(s), under exclusive licence to Federación de Sociedades Españolas de Oncología (FESEO).)
Databáze: MEDLINE
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