Comparison of survival outcomes between radio-chemotherapy and radical hysterectomy with postoperative standard therapy in patients with stage IB1 to IIA2 cervical cancer: long-term oncological outcome analysis in 37 Chinese hospitals

Liu, Ping; Lin, Lihong; Kong, Yanxiang; Huo, Zhifeng; Zhu, Lin; Bin, Xiaonong; Lang, Jinghe; Chen, Chunlin

doi:10.1186/s12885-020-6651-8

Cited by 16 publications

(17 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In addition, patients who received standard postoperative adjuvant treatment were included in this study, and the effects of non-standard postoperative treatment and other factors on the prognosis of patients were excluded. Moreover, the results and conclusions of this study were consistent with previous findings of our team ( 4 ).…”

Section: Discussionsupporting

confidence: 93%

“…After the completion of data entry, two independent gynecologists double-entered the data and checked the information to ensure the accuracy of the data. Relevant data collection and database construction procedures can be found in papers published by our team ( 4 – 8 ). Among them, the cases in this database collected before 2009 were staged by FIGO 1994, and the cases collected after 2009 were staged by FIGO2009.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

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

et al. 2022

Self Cite

View full text Add to dashboard Cite

ObjectiveThis study aimed to explore the best treatment strategy for International Federation of Gynecology and Obstetrics (FIGO) 2018 stage IIA1 cervical cancer patients by comparing the survival outcomes of two treatment methods: abdominal radical hysterectomy (ARH) with standard postoperative therapy and radio-chemotherapy (R-CT).MethodsPatients with FIGO2018 stage IIA1 cervical cancer who underwent ARH or received R-CT were screened from the clinical diagnosis and treatment for cervical cancer in China (Four C) database. The recurrence cases between the two groups were analyzed. The 5-year overall survival (OS) and disease-free survival (DFS) of patients diagnosed with stage IIA1 cervical cancer in 47 hospitals in mainland China between 2004 and 2018 were compared by using propensity score matching (PSM).ResultsA total of 724 patients met the inclusion criteria. In the total study population, The R-CT group had higher recurrence (22.8% for the R-CT group and 11.2% for the ARH group, P<0.001) rates compared to the ARH group.The 5-year OS and DFS of the ARH group (n=658) were significantly higher than those of the R-CT group (n=66) (OS: 85.9% vs. 71.2%, P=0.009; DFS: 79.2%vs. 70.5%, P=0.027). R-CT was associated with worse 5-year OS (HR=3.19, 95% CI: 1.592-6.956, P=0.001) and DFS (HR=2.089, 95% CI: 1.194-3.656, P=0.01). After 1:2 PSM, the 5-year OS and DFS of the ARH group (n=126) were significantly higher than those of the R-CT group (n=64) (OS:88.9% vs. 70.1%, P=0.04; DFS:82.8% vs. 69.8%, P=0.019). R-CT was still associated with worse 5-year OS (HR=2.391, 95% CI: 1.051-5.633, P=0.046) and DFS (HR=2.6, 95% CI: 1.25-5.409, P=0.011).ConclusionOur study demonstrated that for stage FIGO2018 stage IIA1 cervical cancer patients, ARH offers better oncological outcomes than R-CT.

show abstract

Section: Discussionsupporting

confidence: 93%

Section: Methodsmentioning

confidence: 99%

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

et al. 2022

Self Cite

View full text Add to dashboard Cite

show abstract

“…More recently, some studies evaluated the prognostic difference between hysterectomy and primary CRT [ 10 , 21 , 22 ]. The most recent study was a Chinese study that analyzed pooled data on patients with stage IB1-IIA2 cervical cancer (2004–2016) from 37 hospitals [ 22 ]. The matched comparison revealed a better prognosis after hysterectomy than after RT, which was inconsistent with our results.…”

Section: Discussionmentioning

confidence: 99%

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

Lim

Lee

2021

PLoS ONE

View full text Add to dashboard Cite

Purpose Although current clinical guidelines recommend surgery or radiotherapy for non-bulky IB-IIA cervical cancer, clinical data supporting the curative role of radiotherapy in the early-stage disease are insufficient. We evaluated the prognostic implications of definitive radiotherapy and determined its optimal use in clinical practice. Methods Patients with non-bulky (<4 cm) IB-IIA cervical cancer who underwent hysterectomy or primary radiotherapy between 1988 and 2015 were identified from the Surveillance, Epidemiology, and End Results database. Based on the use of brachytherapy and/or chemotherapy, the primary radiotherapy group was classified into three cohorts: hysterectomy vs. radiotherapy overall, with/without brachytherapy and/or chemotherapy (cohort A); radiotherapy and brachytherapy with/without chemotherapy (patients with external beam radiation alone were excluded, cohort B); radiotherapy with brachytherapy and chemotherapy (patients who did not receive chemotherapy were additionally excluded, cohort C). Disease-specific survival (DSS) after hysterectomy was compared to that after primary radiotherapy in each cohort. Results Among the 9,391 initially identified patients, 1,762, 1,244, and 750 patients were classified into cohorts A, B, and C, respectively, after propensity score matching. In cohort A, DSS after primary radiotherapy was inferior to that after hysterectomy (P = 0.001). In cohort B, a trend toward differential survival in favor of hysterectomy was observed with marginal significance (P = 0.061). However, in cohort C, DSS after primary radiotherapy was not significantly different to that after hysterectomy (P = 0.127). According to hazard rate function plots, patients receiving external beam radiation alone had an increased short-term risk of disease-specific mortality, whereas patients without evidence of chemotherapy had a distinct late risk surge at approximately 15 years of follow-up. Conclusion Optimizing radiotherapy methods with brachytherapy and the use of chemotherapy should be considered for the long-term curative efficacy of primary radiotherapy for non-bulky IB-IIA cervical cancer. Further studies are warranted to corroborate our results.

show abstract

“…Clinical diagnosis and treatment for cervical cancer in China (Four C) was approved by the Ethics Committee of the Nanfang Hospital of Southern Medical University (approval number NFEC-2017–135 and clinical trial number CHiCTR1800017778; International Clinical Trials Registry Platform Search Port, http://apps.who.int/trialsearch/ ). Uniformly trained gynaecologists collected the cervical cancer patients’ general data, disease-related examination results, adjuvant treatment data and follow-up data from 2004 to 2018.The clinical staging from 2004 to 2009 were revised according to the 2009 FIGO guidelines while cases in 2018 were staged according to FIGO 2018 [ 15 – 20 ].…”

Section: Methodsmentioning

confidence: 99%

Comparison of survival outcomes between squamous cell carcinoma and adenocarcinoma/adenosquamous carcinoma of the cervix after radical radiotherapy and chemotherapy

Liu

Kong

et al. 2022

BMC Cancer

Self Cite

View full text Add to dashboard Cite

Background This study aimed to compare the survival outcomes between squamous cell carcinoma (SCC) and adenocarcinoma/adenosquamous carcinoma (AC/ASC) of the cervix after radical radiotherapy and chemotherapy. Methods Propensity score matching (1:4) was used to compare overall survival (OS) and disease-free survival (DFS) in cervical cancer patients with SCC and AC/ASC in China. Results Five thousand four hundred sixty-six patients were enrolled according to the criteria. The 5-year OS and DFS in the SCC group (n = 5251) were higher than those in the AC/ASC group (n = 215). After PSM (1:4), the 5-year OS and DFS in the SCC group were higher than those in the AC/ASC group (72.2% vs 56.9%, p < 0.001, HR = 1.895; 67.6% vs 47.8%, p < 0.001, HR = 2.056). In stage I-IIA2 patients, after PSM (1:4), there was no significant difference in 5-year OS between the SCC group (n = 143) and the AC/ASC group (n = 34) (68.5% vs 67.8%, P = 0.175). However, the 5-year DFS in the SCC group was higher than that in the AC/ASC group (71.0% vs 55.7%, P = 0.045; HR = 2.037, P = 0.033). In stage IIB-IV patients, after PSM (1:4), the 5-year OS and DFS in the SCC group (n = 690) were higher than those in the AC/ASC group (n = 173) (70.7% vs 54.3% P < 0.001 vs 1.940%, P < 0.001 vs 45.8%, p < 0.001). Conclusions For stage I-IIA2, there was no significant difference in 5-year survival time, but patients with AC/ASC were more likely to relapse. In the more advanced IIB-IV stage, the oncological outcome of radical radiotherapy and chemotherapy of cervical AC/ASC was worse than that of SCC.

show abstract

Comparison of survival outcomes between radio-chemotherapy and radical hysterectomy with postoperative standard therapy in patients with stage IB1 to IIA2 cervical cancer: long-term oncological outcome analysis in 37 Chinese hospitals

Cited by 16 publications

References 19 publications

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

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

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

Comparison of survival outcomes between squamous cell carcinoma and adenocarcinoma/adenosquamous carcinoma of the cervix after radical radiotherapy and chemotherapy

Contact Info

Product

Resources

About