Neoadjuvant Chemotherapy Followed by Surgery Versus Abdominal Radical Hysterectomy Alone for Oncological Outcomes of Stage IB3 Cervical Cancer—A Propensity Score Matching Analysis
| Autor: | Lixin Sun, Ping Liu, Chunlin Chen, Jianxin Guo, Danbo Wang, Wenling Zhang, Hongwei Zhao, Jinghe Lang, Li Wang, Yi Zhang, Zhumei Cui, Ying Yang, Weili Li, Xiaonong Bin, Wuliang Wang |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Cervical cancer
Cancer Research Chemotherapy medicine.medical_specialty Multivariate analysis oncological outcomes cervical cancer business.industry medicine.medical_treatment Postoperative radiotherapy Neoplasms. Tumors. Oncology. Including cancer and carcinogens medicine.disease Surgery FIGO 2018 Oncology abdominal radical hysterectomy Propensity score matching medicine Overall survival Stage (cooking) Radical Hysterectomy business RC254-282 Original Research neoadjuvant chemotherapy |
| Zdroj: | Frontiers in Oncology, Vol 11 (2021) Frontiers in Oncology |
| ISSN: | 2234-943X |
| Popis: | ObjectiveTo compare the 5-year overall survival (OS) and disease-free survival (DFS) of patients with cervical cancer who received neoadjuvant chemotherapy followed by surgery (NACT) with those who received abdominal radical hysterectomy alone (ARH).MethodsWe retrospectively compared the oncological outcomes of 1410 patients with stage IB3 cervical cancer who received NACT (n=583) or ARH (n=827). The patients in the NACT group were divided into an NACT-sensitive group and an NACT-insensitive group according to their response to chemotherapy.ResultsThe 5-year oncological outcomes were significantly better in the NACT group than in the ARH group (OS: 96.2% vs. 91.2%, respectively, p=0.002; DFS: 92.2% vs. 87.5%, respectively, p=0.016). Cox multivariate analysis suggested that NACT was independently associated with a better 5-year OS (HR=0.496; 95% CI, 0.281-0.875; p=0.015), but it was not an independent factor for 5-year DFS (HR=0.760; 95% CI, 0.505-1.145; p=0.189). After matching, the 5-year oncological outcomes of the NACT group were better than those of the ARH group. Cox multivariate analysis suggested that NACT was still an independent protective factor for 5-year OS (HR=0.503; 95% CI, 0.275-0.918; p=0.025). The proportion of patients in the NACT group who received postoperative radiotherapy was significantly lower than that in the ARH group (pConclusionAmong patients with stage IB3 cervical cancer, NACT improved 5-year OS and was associated with a reduction in the proportion of patients receiving postoperative radiotherapy. These findings suggest that patients with stage IB3 cervical cancer, especially those who are sensitive to chemotherapy, might consider NACT followed by surgery. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|