Effects of preoperative radiotherapy or chemoradiotherapy on postoperative pathological outcome of cervical cancer——from the large database of 46,313 cases of cervical cancer in China

Li, Weili; Liu, Ping; Zhang, Weidong; Yin, Zhaohong; Lin, Zhong; Bin, Xiaonong; Lang, Jinghe; Chen, Chunlin

doi:10.1016/j.ejso.2019.09.188

Cited by 26 publications

(18 citation statements)

References 23 publications

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“…The Four C database was created in cooperation with 47 hospitals in mainland China and includes data on 63,926 cervical cancer patients who were hospitalized between 2004 and 2018. The methods used for data entry, follow-up, double input and database establishment have been described previously ( 14 , 15 ). The clinical staging of the patients in the database was revised according to the new FIGO 2018 staging system ( 1 , 4 ).…”

Section: Methodsmentioning

confidence: 99%

Neoadjuvant Chemotherapy Followed by Surgery Versus Abdominal Radical Hysterectomy Alone for Oncological Outcomes of Stage IB3 Cervical Cancer—A Propensity Score Matching Analysis

Zhang

Sun

et al. 2021

Front. Oncol.

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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 (p<0.001). Compared to the ARH group, the NACT-sensitive group had similar results as the NACT group. The NACT-insensitive group and the ARH group had similar 5-year oncological outcomes and proportions of patients receiving postoperative radiotherapy.ConclusionAmong 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.

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Section: Methodsmentioning

confidence: 99%

Neoadjuvant Chemotherapy Followed by Surgery Versus Abdominal Radical Hysterectomy Alone for Oncological Outcomes of Stage IB3 Cervical Cancer—A Propensity Score Matching Analysis

Zhang

Sun

et al. 2021

Front. Oncol.

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“…Although definitive CRT is considered to be the therapy of choice for LACC, the role of surgery remains controversial [ 5 , 12 , 21 ]. As for neoadjuvant RT before surgery, it is recommended for tumor shrinking, allowing for better surgical resection [ 22 , 23 ], while neoadjuvant CT increases the sensitivity to radiation of the malignant cells [ 24 ]. Tongqing et al [ 25 ] compared the outcomes of patients who were treated with neoadjuvant RT followed by surgery to those who received only surgery, achieving similar five-year OS between the two groups (80% vs. 74.7%).…”

Section: Discussionmentioning

confidence: 99%

The Overall Quality of Life and Oncological Outcomes Following Radical Hysterectomy in Cervical Cancer Survivors Results from a Large Long-Term Single-Institution Study

Stanca

Căpîlna

Trâmbiţaş

et al. 2022

Cancers

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(1) Background: Cervical cancer patients have been found to have worse quality of life (QoL) scores due to cancer treatment, not only when compared to the general population, but also when compared to other gynecological cancer survivors. In Eastern European developing countries, the health care system often cannot afford the uppermost standardized treatment for these patients. In the absence of a comparable study in our country, the authors’ aim for this retrospective cross-sectional observational study was to evaluate the overall survival (OS) and the QoL o cervical cancer survivors; (2) Methods: 430 patients were analyzed. The first objective is to evaluate the OS rates of patients with cervical cancer stages IA2 to IIB undergoing radical hysterectomy (RH) +/− neoadjuvant or adjuvant radiotherapy +/− chemoradiotherapy treatment combinations. The second objective is to assess their QoL, using two standardized questionnaires issued by the European Organisation for Research and Treatment of Cancer (EORTC), namely QLQ-C30 and QLQ-CX24. (3) Results: The mean age of the participants was 51 years (22–76) and the average follow-up time was 65 months (2–128). At the time of the analysis, 308 out of 430 patients were alive, with a mean five-year OS of 72.4%. The multivariate Cox regression analysis identified stage IIB, parametrial invasion, and the lymph node metastases as independent prognostic risk factors negatively impacting the OS. Of the 308 patients still alive at the time of the analysis, 208 (68%) answered the QoL questionnaires. The QLQ-C30 shows a good long-term Global QoL of 64.6 (median), good functioning scores, and a decent symptom scale value. However, the EORTC QLQ-CX24 showed high values of cervical cancer-specific symptoms, namely: lymphedema, peripheral neuropathy, severe menopausal symptoms, and distorted body-image perception. The results also indicate a significant decline in the quality of sexual life with a low sexual enjoyment and decreased level of sexual activities. (4) Conclusion: Despite a good OS, in this setting of patients, cervical cancer survivors have a modest QoL and sexual function. Our study may provide a comparison for future randomized, controlled trials in Eastern European countries needing to confirm these results.

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“…The C4 survey database comprises data on a total of 46 313 women with cervical cancer who were treated between January 1, 2004, and December 31, 2016, in 37 medical institutions in mainland China. Details of the data collection strategy have been described in previous studies 13‐16 . In brief, data collection was carried out by gynecologists using the medical record management system of each hospital.…”

Section: Methodsmentioning

confidence: 99%

Effect of pre‐operative radiotherapy on long‐term outcomes among women with Stage IB1 to IIB cervical squamous cell carcinoma

Liu

Dai

et al. 2020

Intl J Gynecology & Obste

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Objective To compare long‐term outcomes between pre‐operative radiotherapy followed by open surgery and direct open surgery among women with Stage IB1–IIB cervical squamous cell carcinoma. Methods A multicenter retrospective cohort study among women with Stage IB1–IIB cervical squamous cell carcinoma who underwent open surgery either directly (SD group) or with pre‐operative radiotherapy (PR group) in China 2004–2016. Five‐year overall survival (OS) and disease‐free survival (DFS) between the two groups were compared by Kaplan–Meier methods and multivariate Cox regression. Results Overall, 8385 women with Stage IB1–IIB were included (PR group, n = 447; SD group, n = 7938). Five‐year OS and DFS was significantly lower in the PR than in the SD group (OS: 81.7% vs 91.6%, P < 0.001; DFS: 76.3% vs 86.7%, P < 0.001). As compared with direct surgery, pre‐operative radiotherapy was an independent risk factor for 5‐year OS (adjusted hazard raio [aHR], 1.75; 95% confidence interval [CI], 1.34–2.30) and DFS (aHR, 1.37; 95% CI, 1.09–1.73) by multivariate Cox regression. Sensitivity analyses confirmed the findings. Conclusion Among women with Stage IB1–IIB cervical squamous cell carcinoma, outcomes were found to be worse for those undergoing pre‐operative radiotherapy followed by open surgery than for those undergoing direct open surgery.

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Effects of preoperative radiotherapy or chemoradiotherapy on postoperative pathological outcome of cervical cancer——from the large database of 46,313 cases of cervical cancer in China

Cited by 26 publications

References 23 publications

Neoadjuvant Chemotherapy Followed by Surgery Versus Abdominal Radical Hysterectomy Alone for Oncological Outcomes of Stage IB3 Cervical Cancer—A Propensity Score Matching Analysis

Neoadjuvant Chemotherapy Followed by Surgery Versus Abdominal Radical Hysterectomy Alone for Oncological Outcomes of Stage IB3 Cervical Cancer—A Propensity Score Matching Analysis

The Overall Quality of Life and Oncological Outcomes Following Radical Hysterectomy in Cervical Cancer Survivors Results from a Large Long-Term Single-Institution Study

Effect of pre‐operative radiotherapy on long‐term outcomes among women with Stage IB1 to IIB cervical squamous cell carcinoma

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