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

Overview

Journal Front Oncol

Specialty Oncology

Date 2021 Sep 30

PMID 34589433

Citations 3

Authors

Weili Li

Wenling Zhang

Lixin Sun

Li Wang

Zhumei Cui

Hongwei Zhao

Danbo Wang

Yi Zhang

Jianxin Guo

Ying Yang

Wuliang Wang

Xiaonong Bin

Jinghe Lang

Ping Liu

Chunlin Chen

Affiliations

Soon will be listed here.

Abstract

Objective: To 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).

Methods: We 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.

Results: The 5-year oncological outcomes were significantly better in the NACT group than in the ARH group (OS: 96.2% 91.2%, respectively, =0.002; DFS: 92.2% 87.5%, respectively, =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; =0.015), but it was not an independent factor for 5-year DFS (HR=0.760; 95% CI, 0.505-1.145; =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; =0.025). The proportion of patients in the NACT group who received postoperative radiotherapy was significantly lower than that in the ARH group (<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.

Conclusion: Among 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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