Responsiveness of neoadjuvant chemotherapy before surgery predicts favorable prognosis for cervical cancer patients: a meta-analysis

Ye, Qing; Yuan, Haiyan; Chen, Honglin

doi:10.1007/s00432-013-1509-y

Cited by 33 publications

(32 citation statements)

References 23 publications

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“…Scholars (Xiong and colleagues) in Sun Yat-Sen University demonstrated that non-responders had relatively lower survival rates than responders [21]; others (Li and colleagues at Chongqing Medical University; Chen and colleagues at Wuhan University) also made the similar discovery [22, 23]. This study also validated other researchers’ findings as well as our previous results [19, 21–24]. Thus, we believe that early clinical response to chemotherapy can be treated as an indicator to DFS.…”

Section: Discussionsupporting

confidence: 89%

Early response to neoadjuvant chemotherapy can help predict long-term survival in patients with cervical cancer

Huang

Zhang

et al. 2016

Oncotarget

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It is still controversial whether cervical cancer patients with clinical responses after neoadjuvant chemotherapy (NACT) have a better long-term survival or not. This study was designed to investigate the effect of the clinical response on the disease-free survival (DFS) of cervical cancer patients undergoing NACT. A total of 853 patients from a retrospective study were used to evaluate whether the clinical response was an indicator for the long-term response, and 493 patients from a prospective cohort study were used for further evaluation. The survival difference was detected by log-rank test, univariate and multivariate Cox regression and a pooled analysis. The log-rank test revealed that compared with non-responders, the DFS of responders was significantly higher in the retrospective data (P = 0.007). Univariate Cox regression showed that the clinical response was an indicator of long-term survival in the retrospective study (HR 1.83, 95% CI 1.18-2.85, P = 0.007). In a multivariate Cox model, the clinical response was still retained as an independent significant prognostic factor in the retrospective study (HR 1.59, 95% CI 1.01-2.50, P = 0.046). The result was also validated in the prospective data with similar results. These findings implied that the clinical response can be regarded as an independent predictor of DFS.

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Section: Discussionsupporting

confidence: 89%

Early response to neoadjuvant chemotherapy can help predict long-term survival in patients with cervical cancer

Huang

Zhang

et al. 2016

Oncotarget

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“…Additionally, this finding is validated by a meta-analysis where Ye et al . pooled data from 18 studies and reported that the response to NACT was significantly associated with better survival outcomes [37]. The largest study that assessed the long-term benefits of NACT was conducted by Alessandro et al .…”

Section: Discussionmentioning

confidence: 99%

Impact of Hyperglycemia on Outcomes among Patients Receiving Neoadjuvant Chemotherapy for Bulky Early Stage Cervical Cancer

et al. 2016

PLoS ONE

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BackgroundThe impact of hyperglycemia on survival of patients undergoing neoadjuvant chemotherapy (NACT) for bulky early stage cervical cancer (BESCC) has not been explored.MethodRecords of patients who received NACT and radical hysterectomy in our institution between January 2005 and June 2010 were reviewed.ResultsIn total, 347 patients were included. The median follow-up time was 37 months (range: 4–65). Patients with hyperglycemia (fasting blood glucose ≥ 100 mg/dl) had shorter recurrence-free survival (RFS) (univariate hazard ratio [HR] = 1.95, 95% confidence interval [CI] [1.16, 3.28], P = 0.010) and cancer-specific survival (CSS) (univariate HR = 2.24, 95% CI [1.33, 3.78], P = 0.002) compared with those with euglycemia (fasting blood glucose <100 mg/dl). In multivariate analysis, positive surgical margins, parametrium invasion, node metastasis, hyperglycemia and complete response to NACT independently predicted recurrence and cancer-specific death. To further validate the prognostic value of hyperglycemia, we conducted a subgroup analysis based on patient baseline characteristics and prognostic effect of hyperglycemia remained significant in all subgroups. On multivariable logistic regression analysis, euglycemia before NACT, squamous cell tumor and pre-treatment squamous cell carcinoma antigen levels < 3.5 ng/ml were identified as independent predictors of complete response after NACT.ConclusionsFBG ≥100 mg/dl is a negative prognostic predictor for cervical cancer patients receiving NACT for BESCC. Patients with hyperglycemia are less likely to achieve complete response after NACT. Our findings underscore the clinical utility of hyperglycemia screening of for cervical cancer patients.

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“…For patients with LACC, achieving optimal pathological response on surgical specimen is a strong predictor of good clinical outcome 36, 37. The study by Alessandro et al.…”

Section: Discussionmentioning

confidence: 99%

Pretreatment serum lactate dehydrogenase is an independent prognostic factor for patients receiving neoadjuvant chemotherapy for locally advanced cervical cancer

et al. 2016

Cancer Medicine

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For locally advanced cervical cancer (LACC), hypoxia is a characteristic property. This study aimed to investigate whether baseline lactic dehydrogenase (LDH) level, which is a marker of hypoxia, had clinical value in determining neoadjuvant chemotherapy (NACT) response and prognosis for LACC patients. The study cohort included 418 patients with a median follow‐up of 37.5 months. Cox proportional hazards models were used to assess the prognostic value of baseline LDH levels. Multivariate logistic regression analysis was performed to identify independent predictors of complete response after NACT. Backward stepwise selection with the Akaike information criterion was used to identify factors that could be entered into the multivariate regression model. Compared with patients with LDH levels <252.0 μ/L, patients with LDH levels ≥252.0 μ/L were more likely to have an elevated level of squamous cell carcinoma antigen, lymphatic vascular space involvement, lymph node metastasis, and positive parametrium and achieved lower complete remission rates. Baseline LDH levels ≥252.0 μ/L was an independent prognosticator for recurrence‐free survival (adjusted hazard ratio [HR], 3.56; 95% confidence interval [CI] 2.22–5.69; P < 0.0001) and cancer‐specific survival (adjusted HR, 3.08; 95% CI, 1.89–5.01; P < 0.0001). The predictive value of baseline LDH value remained significant in the subgroup analysis. LDH level ≥252.0 μ/L was identified as an independent predictor of complete remission after NACT (adjusted odds ratio [OR], 0.29; 95% CI, 0.15–0.58; P < 0.0001). Baseline LDH ≥252.0 μ/L is an independent prognostic predictor for patients receiving neoadjuvant chemotherapy for LACC. It helps distinguish patients with different prognosis and select patients who are more likely to benefit from NACT.

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Responsiveness of neoadjuvant chemotherapy before surgery predicts favorable prognosis for cervical cancer patients: a meta-analysis

Abstract: This meta-analysis confirms that response to NAC is an indicator for PFS and OS, and suggests that patients-achieving response of NAC before surgery predicts favorable prognosis for cervical cancer patients.

Cited by 33 publications

References 23 publications

Early response to neoadjuvant chemotherapy can help predict long-term survival in patients with cervical cancer

Early response to neoadjuvant chemotherapy can help predict long-term survival in patients with cervical cancer

Impact of Hyperglycemia on Outcomes among Patients Receiving Neoadjuvant Chemotherapy for Bulky Early Stage Cervical Cancer

Pretreatment serum lactate dehydrogenase is an independent prognostic factor for patients receiving neoadjuvant chemotherapy for locally advanced cervical cancer

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