Primary radical hysterectomy vs chemoradiation for IB2-IIA cervical cancer

Yan, Ruo-Nan; Zeng, Zhen; Liu, Fang; Zeng, Yuanyuan; He, Tao; Zhang, Bailu; Gong, Hanlin; Liu, Lei

doi:10.1097/md.0000000000018738

Cited by 12 publications

(10 citation statements)

References 31 publications

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“…From our perspective, the implementation of the new FIGO 2019 classification enables us to make a better decision about a stage adapted therapy. In other words, it helps us better to avoid unnecessary multimodal therapy [ 36 , 37 ]. Our findings are in good agreement with previous results [ 35 ].…”

Section: Discussionmentioning

confidence: 99%

Retrospective Analysis of Cervical Cancer Treatment Outcomes: Ten Years of Experience with the Vaginal Assisted Radical Laparoscopic Hysterectomy VARLH

Wojdat

Malanowska

2022

BioMed Research International

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Background. LACC trial demonstrated inferiority of laparoscopic approach for the treatment of early-stage cervical cancer. There are still limited data from retrospective trials regarding whether survival outcomes after laparoscopic radical hysterectomy are equivalent to those after open abdominal radical hysterectomy. In this study, we present results of combined vaginal radical laparoscopic hysterectomy in the treatment of early-stage cervical cancer. Methods. This retrospective study was carried out at the Department of Gynecology in Mathilden Hospital (Herford, Germany). Between January 2008 and April 2018, all the patients with invasive cervical cancer who underwent combined vaginal assisted radical laparoscopic hysterectomy (VARLH) without the use of any uterine manipulator were enrolled to the study. Results. A total number of 124 patients with diagnosis of invasive cervical cancer were enrolled in the study. All of the patients underwent minimally invasive surgery and were divided according to FIGO 2019: stage IA (25.9%), IB1 (25.0%), IB2-IIB (28.4%), and III/IV (20.7%). Overall, the mean age of the patients was 51.84 years. After a study collection, a median follow-up was 45.6 (range 23.7-76.5) months. The 3- and 5-year disease-free survival rates for early-stage cervical cancer were both 98%, and the 3- and 5-year overall survival rates were 100% and 97%, respectively. We have not observed any recurrence in our study group of patients with early-stage cervical cancer. Conclusions. Combined VARLH can be considered a safe and effective procedure for the treatment of early-stage cervical cancer. Surgical strategy with oncological principles determines the quality and long-term success of the operation in early cervical cancer regardless of laparoscopic approach.

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Section: Discussionmentioning

confidence: 99%

Retrospective Analysis of Cervical Cancer Treatment Outcomes: Ten Years of Experience with the Vaginal Assisted Radical Laparoscopic Hysterectomy VARLH

Wojdat

Malanowska

2022

BioMed Research International

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“…Chemotherapy might be not a protective factor for overall survival of stage I or II CC patients with a HR of 1.31(95% CI 0.46–3.73, P > 0.05) [ 37 ]. The overall survival of cervical cancer patients receiving radical hysterectomy was superior to that of patients receiving chemoradiotherapy for CC patients with stage IB–IIA [ 38 ]. These previous studies demonstrated that radiotherapy and chemotherapy might not be the best treatments for CC patients with stage I.…”

Section: Discussionmentioning

confidence: 99%

Improve individual treatment by comparing treatment benefits: cancer artificial intelligence survival analysis system for cervical carcinoma

Liang

et al. 2022

J Transl Med

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Purpose The current study aimed to construct a novel cancer artificial intelligence survival analysis system for predicting the individual mortality risk curves for cervical carcinoma patients receiving different treatments. Methods Study dataset (n = 14,946) was downloaded from Surveillance Epidemiology and End Results database. Accelerated failure time algorithm, multi-task logistic regression algorithm, and Cox proportional hazard regression algorithm were used to develop prognostic models for cancer specific survival of cervical carcinoma patients. Results Multivariate Cox regression identified stage, PM, chemotherapy, Age, PT, and radiation_surgery as independent influence factors for cervical carcinoma patients. The concordance indexes of Cox model were 0.860, 0.849, and 0.848 for 12-month, 36-month, and 60-month in model dataset, whereas it were 0.881, 0.845, and 0.841 in validation dataset. The concordance indexes of accelerated failure time model were 0.861, 0.852, and 0.851 for 12-month, 36-month, and 60-month in model dataset, whereas it were 0.882, 0.847, and 0.846 in validation dataset. The concordance indexes of multi-task logistic regression model were 0.860, 0.863, and 0.861 for 12-month, 36-month, and 60-month in model dataset, whereas it were 0.880, 0.860, and 0.861 in validation dataset. Brier score indicated that these three prognostic models have good diagnostic accuracy for cervical carcinoma patients. The current research lacked independent external validation study. Conclusion The current study developed a novel cancer artificial intelligence survival analysis system to provide individual mortality risk predictive curves for cervical carcinoma patients based on three different artificial intelligence algorithms. Cancer artificial intelligence survival analysis system could provide mortality percentage at specific time points and explore the actual treatment benefits under different treatments in four stages, which could help patient determine the best individualized treatment. Cancer artificial intelligence survival analysis system was available at: https://zhangzhiqiao15.shinyapps.io/Tumor_Artificial_Intelligence_Survival_Analysis_System/.

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“…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 ].…”

Section: Discussionmentioning

confidence: 99%

“…The policy suggesting either local treatment option is mainly based on one randomized trial that reported similar survival outcomes with the two local treatment options [7]. In contrast, other observational studies and meta-analyses have consistently reported the superiority of hysterectomy over RT [8][9][10][11]. Owing to insufficient high-level evidence, it is uncertain whether these findings are applicable to clinical practice.…”

Section: Introductionmentioning

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

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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.

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Primary radical hysterectomy vs chemoradiation for IB2-IIA cervical cancer

Cited by 12 publications

References 31 publications

Retrospective Analysis of Cervical Cancer Treatment Outcomes: Ten Years of Experience with the Vaginal Assisted Radical Laparoscopic Hysterectomy VARLH

Retrospective Analysis of Cervical Cancer Treatment Outcomes: Ten Years of Experience with the Vaginal Assisted Radical Laparoscopic Hysterectomy VARLH

Improve individual treatment by comparing treatment benefits: cancer artificial intelligence survival analysis system for cervical carcinoma

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

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