Chemoradiotherapy in combination with radical surgery is associated with better outcome in cervical cancer patients

Abstract

ObjectivesTo retrospectively assess the influence of radical surgery following concurrent chemoradiotherapy (CCRT) on outcomes in cervical cancer (CC) patients.MethodsPatients diagnosed with cervical squamous cell carcinoma or adenocarcinoma (FIGO stages IB2 to IIB) at the Yinbin Second People's Hospital between September 2008 and September 2013, were included in this study. Patients were classified into 2 groups based on the treatment received: surgery group (CCRT plus radical surgery) and non-surgery groups (CCRT only). In addition to clinical information, inter-group differences with respect to local control rate (LCR), local recurrence rate (LRR), metastasis rate, overall survival (OS), progress free survival(PFS) and complications were assessed.ResultsA total of 314 patients were included in the analysis. Parametrial invasion, pelvic lymph node metastasis, tumor diameter > 4 cm and presence of residual disease were risk factors for recurrence in the non-surgery group. In patients with risk factors, radical surgery significantly improved their clinical outcome. The 3-year/5-year LCR in the surgery and non-surgery groups was 88.3%/87.4% and 82.3%/77.5%, respectively (P = 0.04). The 3-year/5-year OS rate in the two groups was 87.1%/81.7% and 72.8%/67.3%, respectively (P = 0.001). The 3-year/5-year LRR in the two groups were 11.7%/12.6% and 17.7%/22.5%, respectively (P = 0.04). The metastasis rates in the two groups were 19.9% and 24.8%, respectively (P = 0.09).ConclusionsSurgery following CCRT could improve overall survival and progressfree survival. Radical surgery following CCRT appears to confer significant benefits including an increase in LCRs and decrease in LRR in CC patients with risk factors.

Chemoradiotherapy alone vs. chemoradiotherapy and hysterectomy for locally advanced cervical cancer: A systematic review and updated meta‑analysis

“…Of the eligible records identified, 22 were subjected to full-text review, eight of which ( 7 , 9 , 18 – 23 ) were excluded for the following reasons: A total of two studies used only radiotherapy ( 22 , 23 ), two were non-comparative studies ( 7 , 19 ), one study included a large cohort of patients with stage I cancer ( 21 ), one study evaluated patients with stage IVB cervical cancer ( 18 ), one study had duplicate data ( 9 ) and the full-text of one study was unavailable ( 20 ). Finally, data from 14 studies were included in this systematic review and meta-analysis ( 11 , 12 , 24 – 35 ).…”

“…In another study, Cetina et al ( 31 ) did not obtain any differences in OS or DFS when comparing patients with patients stage IB2-IIB LACC undergoing external beam radiotherapy (EBRT) with chemotherapy followed by either hysterectomy or brachytherapy. Given the limitations of both of these RCTs, numerous clinicians have reported their experience regarding the role of adjuvant hysterectomy, but by means of retrospective studies ( 11 , 12 , 24 – 30 , 33 – 35 ). The present review was performed to provide comprehensive and updated evidence on this subject.…”

Disfunção sexual após tratamento para o câncer do colo do útero

“…Depending on the stage, treatment for cervical cancer ranges from surgery as the single treatment to a combination of radiotherapy, chemotherapy and surgery in specific situations (18)(19) . The type of treatment will also depend on personal factors (such as desire for pregnancy and the woman's age) and risk factors associated with the tumor (tumor size, lymphatic invasion, stromal invasion, involvement of surgical margins, lymph node involvement, among others) (20) .…”

Combination of Berberine and Matrine Affects Apoptosis and Cellcycle in Human Cervical Cancer Cells

“…After the cells had attached, the medium in all wells was replaced with fresh culture medium for the controls or medium containing the respective compound concentrations. Four replicates of each concentration were tested to investigate the effect of berberine (3, 10, 30, 100, and 300 µmol/L) and matrine (1,3,10,30, and 100 mmol/L) against HeLa and SiHa cells. After incubating for 24 h, 20 µL of 5 mg/mL 3-(4,5dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) solution was added to each well, followed by incubation for 4 h in the incubator, after which the supernatant in each well was carefully discarded (24)(25).…”

“…Since the beginning of the last century, the main treatment strategy for cervical cancer has been surgery (2). The current clinical treatment of cervical cancer involves simple uterine radical resection or combined radiotherapy and chemotherapy (3). Although these treatment options offer more choices, most patients are initially diagnosed with advanced cervical cancer, and radiotherapy has become one of the main treatments at this stage.…”