Comparison of Survival Outcomes Between Radical Hysterectomy and Definitive Radiochemotherapy in Stage IB1 and IIA1 Cervical Cancer

Overview

Journal Cancer Manag Res

Publisher Dove Medical Press

Specialty Oncology

Date 2017 Dec 23

PMID 29270030

Citations 10

Authors

San-Gang Wu

Wen-Wen Zhang

Zhen-Yu He

Jia-Yuan Sun

Yan Wang

Juan Zhou

Affiliations

Soon will be listed here.

Abstract

Introduction: There is an ongoing debate regarding the optimal local treatment modalities for stage IB1 and IIA1 cervical cancer. The aim of this study was to determine whether radical hysterectomy or definitive radiochemotherapy is superior in stage IB1 and IIA1 cervical squamous cell carcinoma (SCC).

Methods: From 1990 to 2010, a total of 3,769 patients with stage IB1 and IIA1 cervical SCC were included from the Surveillance, Epidemiology, and End Results database and were stratified according to whether they received radical hysterectomy or primary radiochemotherapy. Propensity score-matching (PSM) methods were used to balance patient baseline characteristics. Cancer-specific survival (CSS) and overall survival (OS) were compared between the two groups.

Results: Of the 3,769 patients, 3,653 (96.9%) and 116 (3.1%) patients received radical hysterectomy and definitive radiochemotherapy, respectively. Radiochemotherapy was rarely used for definitive treatment prior to 2000. Before PSM, patients who were older, of black ethnicity, and with larger tumor size and stage IIA1 disease were more likely to receive definitive radiochemotherapy. A total of 116 pairs were completely matched using PSM. The local treatment modalities had no effect on CSS or OS in either unmatched or matched populations. In the matched population, the 8-year CSS rates were 82.1% and 76.5% in surgery and radiochemotherapy groups, respectively (=0.382). The 8-year OS rates were 74.6% and 67.8% in surgery and radiochemotherapy groups, respectively (=0.205).

Conclusion: Our population-based study suggests that there is no clear local treatment of choice on survival outcomes between radical hysterectomy and definitive radiochemotherapy in patients with stage IB1 and IIA1 cervical SCC.

Citing Articles

A Diagnostic Nomogram Incorporating Prognostic Nutritional Index for Predicting Vaginal Invasion in Stage IB - IIA Cervical Cancer.

Xie N, Lin J, Yu H, Liu L, Deng S, Liu L Cancer Control. 2024; 31:10732748241278479.

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Treatment of FIGO 2018 stage IIIC cervical cancer with different local tumor factors.

Ye Y, Li Z, Kang S, Yang Y, Ling B, Wang L BMC Cancer. 2023; 23(1):421.

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Discussion on the Treatment Strategy for Stage ⅡA1 Cervical Cancer (FIGO 2018).

Chen X, Liang W, Duan H, Wu M, Zhan X, Dai E Front Oncol. 2022; 12:800049.

PMID: 35494051 PMC: 9046906. DOI: 10.3389/fonc.2022.800049.

Development and Validation of Novel Nomograms to Predict the Overall Survival and Cancer-Specific Survival of Cervical Cancer Patients With Lymph Node Metastasis.

Yi J, Liu Z, Wang L, Zhang X, Pi L, Zhou C Front Oncol. 2022; 12:857375.

PMID: 35372011 PMC: 8968041. DOI: 10.3389/fonc.2022.857375.

Optimal use of radiotherapy in the definitive treatment of non-bulky IB-IIA cervical cancer: A population-based long-term survival analysis.

Lim Y, Lee H PLoS One. 2021; 16(6):e0253649.

PMID: 34166433 PMC: 8224971. DOI: 10.1371/journal.pone.0253649.

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