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The role of additional hysterectomy after concurrent chemoradiation for patients with locally advanced cervical cancer
- Source :
- International Journal of Clinical Oncology. 25:384-390
- Publication Year :
- 2019
- Publisher :
- Springer Science and Business Media LLC, 2019.
-
Abstract
- The standard treatment for cervical cancer is chemoradiation although some patients showed treatment resistance. The purpose of this study was to investigate the clinical efficacy of surgery after chemoradiation for cervical cancer. Patients with FIGO stage IB2 to IIB cervical cancer were included in the study between 2005 and 2015. A total of 50 patients who underwent surgery after neoadjuvant chemoradiation and 76 patients who received only chemoradiation were compared. Baseline differences between the two groups were adjusted with inverse probability of treatment weighting method using propensity scores composed of the following independent variables: age, stage, tumor size, lymph node metastasis, and histological subtypes. Median follow-up was 64.8 (range 4.8–143.9) months. After adjustment with inverse probability of treatment weighting, Kaplan–Meier curves showing adjusted progression-free survival and overall survival were significantly longer in the neoadjuvant chemoradiation compared with the chemoradiation-only group (p = 0.027 and p = 0.017, respectively). Moreover, in patients with squamous cell carcinoma, recurrence in previously irradiated field and recurrence both in and out of previously irradiated field were significantly decreased in the neoadjuvant chemoradiation compared with the chemoradiation-only group (3.1% and 18.4%, respectively; OR 0.142, p = 0.001]. Adverse events of surgery after chemoradiation were acceptable, although temporary hydronephrosis was frequently observed (23.1%). Surgery after chemoradiation reduced pelvic recurrence, and as a result, patients who underwent neoadjuvant chemoradiation showed more favorable survival outcomes compared with those who only underwent chemoradiation.
- Subjects :
- Adult
0301 basic medicine
medicine.medical_specialty
medicine.medical_treatment
Urology
Uterine Cervical Neoplasms
Kaplan-Meier Estimate
Hysterectomy
03 medical and health sciences
0302 clinical medicine
Postoperative Cognitive Complications
Surgical oncology
medicine
Humans
Stage (cooking)
Adverse effect
Neoadjuvant therapy
Aged
Retrospective Studies
Cervical cancer
business.industry
Standard treatment
Chemoradiotherapy
Hematology
General Medicine
Middle Aged
medicine.disease
Neoadjuvant Therapy
Treatment Outcome
030104 developmental biology
Oncology
Lymphatic Metastasis
030220 oncology & carcinogenesis
Propensity score matching
Carcinoma, Squamous Cell
Female
Surgery
Neoplasm Recurrence, Local
business
Subjects
Details
- ISSN :
- 14377772 and 13419625
- Volume :
- 25
- Database :
- OpenAIRE
- Journal :
- International Journal of Clinical Oncology
- Accession number :
- edsair.doi.dedup.....eb306d8e38c2134dfb2ed00fb519dd61