Survival impact of additional chemotherapy after adjuvant concurrent chemoradiation in patients with early cervical cancer who underwent radical hysterectomy

BMC Cancer

Tae Hun Kim¹  Hye Won Jeon¹  Taek Sang Lee¹  Se Ik Kim²  Hee Seung Kim²  Hyun Hoon Chung²  Noh Hyun Park²  Jeong Yun Kim²  Yong Sang Song²  Maria Lee²  Chan Woo Wee³ 

[1] Department of Obstetrics and Gynecology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, 20, Boramae-ro 5-gil, Dongjak-gu, 07061, Seoul, Republic of Korea;Department of Obstetrics and Gynecology, Seoul National University College of Medicine, 101, Daehak-ro, Jongno-gu, 03080, Seoul, Republic of Korea;Department of Radiation Oncology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, 20, Boramae-ro 5-gil, Dongjak-gu, 07061, Seoul, Republic of Korea;

关键词: Uterine cervical neoplasms;    Hysterectomy;    Chemoradiotherapy;    Chemotherapy, adjuvant;    Prognosis;   

DOI  :  10.1186/s12885-021-08940-z

来源: Springer

【 摘 要 】

BackgroundTo determine whether additional chemotherapy after concurrent chemoradiation (CCRT) improves survival outcomes in patients with early cervical cancer who undergo radical hysterectomy (RH).MethodsWe included high- or intermediate-risk patients from two institutions, with 2009 FIGO stage IB–IIA, who underwent primary RH and pelvic lymphadenectomy between January 2007 and June 2020, and had completed adjuvant CCRT. Survival outcomes were compared between patients who received additional chemotherapy (study group) and those who did not (control group).ResultsA total of 198 patients were included in this analysis. The study (n = 61) and control groups (n = 137) had similar patient age, histologic cancer type, 2009 FIGO stage, and tumor size. However, minimally invasive surgery was performed less frequently in the study group than in the control group (19.7% vs. 46.0%, P < 0.001). The presence of pathologic risk factors was similar, except for lymph node metastasis, which was more frequent in the study group (72.1% vs. 46.0%; P = 0.001). In survival analyses, no differences in the disease-free survival (DFS; P = 0.539) and overall survival (OS; P = 0.121) were observed between the groups. Multivariate analyses adjusting for surgical approach and other factors revealed that additional chemotherapy was not associated with DFS (adjusted HR, 1.149; 95% CI, 0.552–2.391; P = 0.710) and OS (adjusted HR, 1.877; 95% CI, 0.621–5.673; P = 0.264). The recurrence patterns did not differ with additional chemotherapy. Consistent results were observed in a subset of high-risk patients (n = 139).ConclusionsAdditional chemotherapy after CCRT might not improve survival outcomes in patients with early cervical cancer who undergo RH.

【 授权许可】

CC BY