Efficacy of neoadjuvant chemotherapy in patients with FIGO stage IB1 to IIA cervical cancer: An international collaborative meta-analysis

Kim, H.S.; Sardi, Juan; Katsumata, Noriyuki; Ryu, Hee Sug; Nam, Joo Hyun; Chung, Hyun Hoon; Park, N.H.; Song, Yong Sang; Behtash, Nadereh; Kamura, Toshiharu; Cai, Hongwei; Kim, J.W.

doi:10.1016/j.ejso.2012.09.003

Cited by 139 publications

(107 citation statements)

References 23 publications

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“…Because of these advantages, NACT is used in up to 25% of cervical cancer patients in many parts of the world, such as Asia, Italy, and South America 6. On the other hand, there are several objections because for patients with locally advanced cervical cancer (LACC) who do not response to NACT, the delay in curative treatment, the development of radio‐resistant cellular clones and cross‐resistance with radiotherapy may exert negative impact on patient survival 7. Given these controversies, NACT is not recommended as a routine treatment for LACC patients in current National Comprehensive Cancer Network (NCCN) Clinical Practice guideline 1.…”

Section: Introductionmentioning

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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Section: Introductionmentioning

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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“…In accordance with this data, by using a neoadjuvant chemotherapy, the percentage of patients in need for adjuvant radiochemotherapy could be significantly lowered (OR 0.57, 95% CI 0.33-0.98) [4]. …”

Section: Adjuvant Chemotherapymentioning

confidence: 57%

“…Summarizing all previously mentioned published data on patients undergoing a neoadjuvant chemotherapy, the rate of complete resection was improved (OR 1.55, 95% CI 0.96-2.50; P = 0.07) [4]; the incidence of positive lymph nodes could be reduced (OR 0.54, 95% CI 0.40-0.73; P < 0.0001), as could the rate of patients with parametric infiltration (OR 0.58, 95% CI 0.41-0.82; P = 0.002) and the probability of distant metastasis (OR 0.72, 95% CI 0.45-1.14; P = 0.16) [4]. In accordance with this data, by using a neoadjuvant chemotherapy, the percentage of patients in need for adjuvant radiochemotherapy could be significantly lowered (OR 0.57, 95% CI 0.33-0.98) [4].…”

Section: Adjuvant Chemotherapymentioning

confidence: 99%

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Neoadjuvant and Adjuvant Chemotherapy of Cervical Cancer

Mallmann

Mallmann²

2016

Oncol Res Treat

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Neoadjuvant chemotherapy is indicated in patients who can tolerate the side effects of a chemotherapy and with preoperative presentation of one of the following clinical risk situations: bulky disease with a maximal tumor diameter of > 4 cm, suspicious lymph nodes in magnetic resonance imaging (MRI), computed tomography (CT) scan or endosonography, histopathologically confirmed lymph node metastasis, or histopathologically documented risk factors such as G3 and L1V1. A neoadjuvant chemotherapy followed by surgery should be performed with cisplatin at a dosage of > 25 mg/m² per week and an application interval of < 14 days. The previously published data suggests an improved rate of complete resection and reduced incidences of positive lymph nodes and parametric infiltration. Accordingly, the percentage of patients in need for adjuvant radiochemotherapy after operation can be significantly reduced. Some studies demonstrated a prolongation of progression-free and overall survival. Following the previously published studies, adjuvant chemotherapy after operation or after radiochemotherapy has no significant effect on the overall survival and, following the current guidelines, should be avoided.

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“…In addition, it has previously been repeatedly shown that neoadjuvant chemotherapy is effective in decreasing the size of the tumor and the prevalence of lymph node involvement, especially the presence of micrometastases, 8 and therefore consequently diminishing the need for adjuvant treatment. 7,9 A combination of less radical surgery, together with less need for adjuvant radiotherapy, should result in a significant improvement in long-term morbidity and quality of life.…”

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confidence: 99%

A Novel Perspective of Neoadjuvant Chemotherapy in Locally Advanced Cervical Cancer

Cibula

2015

Ann Surg Oncol

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Efficacy of neoadjuvant chemotherapy in patients with FIGO stage IB1 to IIA cervical cancer: An international collaborative meta-analysis

Cited by 139 publications

References 23 publications

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

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

Neoadjuvant and Adjuvant Chemotherapy of Cervical Cancer

A Novel Perspective of Neoadjuvant Chemotherapy in Locally Advanced Cervical Cancer

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