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Outcome of International Federation of Gynecology and Obstetrics Stage IIB Cervical Cancer From 2003 to 2012: An Evaluation of Treatments and Prognosis
  1. Lili Guo, MM*,,
  2. Xiaoyan Liu, MM*,
  3. Lin Wang, MB*,
  4. Haiying Sun, MM*,
  5. Kecheng Huang, MM*,
  6. Xiong Li, MM*,
  7. Fangxu Tang, MD*,
  8. Shuang Li, MD*,
  9. Xianglin Yuan, MD and
  10. Changyu Wang, MD*
  1. *Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China;
  2. Department of Obstetrics and Gynecology, Taihe Hospital, Hu Bei Medical University, Shiyan City, Hubei Province, People’s Republic of China; and
  3. Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China.
  1. Address correspondence and reprint requests to Changyu Wang, MD, Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Ave, Wuhan, Hubei 430030, People’s Republic of China. E-mail: tjwcy66@qq.com.

Abstract

Objective To compare the clinical outcomes of patients with International Federation of Gynecology and Obstetrics (FIGO) stage IIB cervical carcinoma receiving neoadjuvant chemotherapy followed by radical hysterectomy (RH) with those of patients receiving chemoradiation therapy (CRT) alone.

Methods We retrospectively reviewed the medical records of patients with FIGO stage IIB cervical carcinoma. A total of 621 patients were eligible for the study according to the surgery-based or radiotherapy-based treatment; 285 patients received cisplatin-based neoadjuvant chemotherapy (NACT) followed by RH, and 336 patients underwent sequential or concurrent chemoradiation. The disease-free survival, overall survival, recurrence rates, and late complications were compared. Cox regression analysis was used to identify potential prognostic factors.

Results Complete or partial response was seen in 77.6% (221/285) of the NACT-treated patients. Disease-free survival and overall survival rates of the patients who had NACT-sensitive responses were significantly higher than those who did not response (P = 0.021 and P = 0.008). Overall survival rates in the NACT + RH group were comparable with the concurrent chemoradiotherapy or chemoradiation groups (P > 0.05). Neoadjuvant chemotherapy followed by RH significantly decreased the recurrence rate (22.6% vs 35.5%), resulted in fewer treatment-related complications, and ultimately improved survival when compared with concurrent CRT. A survival benefit was observed for 63.9% of the patients in the NACT + RH group without adjuvant radiotherapy or CRT.

Conclusions Compared with concurrent chemoradiotherapy, NACT followed by RH achieved comparable survival outcomes for patients with FIGO stage IIB cervical cancer. This treatment method was significantly effective at reducing radiotherapy rates and complications, and it is worthy of recommending for younger patients.

  • Cervical cancer
  • Concurrent chemoradiotherapy
  • Neoadjuvant chemotherapy
  • Radical hysterectomy

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Footnotes

  • Supported by the National Science Foundation of China (No. 30943187). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

  • The authors declare no conflicts of interest.

  • Supplemental digital content is available for this article. Direct URL citation appears in the printed text and is provided in the HTML and PDF versions of this article on the journal’s Web site (www.ijgc.net).

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