Neoadjuvant chemotherapy for advanced stage endometrial cancer: A systematic review

Objective: While primary cytoreductive surgery (PCS) is considered the standard of care for women who present with stage IV endometrial cancer, neoadjuvant chemotherapy (NACT) followed by interval cytoreductive surgery (ICS) has emerged as an alternative treatment strategy. We summarized the literat...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Allan B. Huang, Jenny Wu, Ling Chen, Benjamin B. Albright, Rebecca A. Previs, Haley A. Moss, Brittany A. Davidson, Laura J. Havrilesky, Alexander Melamed, Jason D. Wright
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Endometrial cancer Uterine cancer Hysterectomy Neoadjuvant Cytoreduction Debulking Gynecology and obstetrics RG1-991 Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/487cccd14cec469c978d5f218e10b84c
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:487cccd14cec469c978d5f218e10b84c
record_format	dspace
spelling	oai:doaj.org-article:487cccd14cec469c978d5f218e10b84c2021-11-12T04:41:37ZNeoadjuvant chemotherapy for advanced stage endometrial cancer: A systematic review2352-578910.1016/j.gore.2021.100887https://doaj.org/article/487cccd14cec469c978d5f218e10b84c2021-11-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2352578921001910https://doaj.org/toc/2352-5789Objective: While primary cytoreductive surgery (PCS) is considered the standard of care for women who present with stage IV endometrial cancer, neoadjuvant chemotherapy (NACT) followed by interval cytoreductive surgery (ICS) has emerged as an alternative treatment strategy. We summarized the literature and compared outcomes of PCS compared to NACT and ICS. Methods: We conducted a systematic search on PubMed, Embase, Web of Science, and Scopus for articles published from January 1, 1990 to December 31, 2020. Key search terms included multiple descriptors of advanced disease status in combination with “endometrial cancer” and “neoadjuvant chemotherapy”. Our review included studies that examined survival and surgical outcomes of patients with stage III or IV endometrial cancer treated with neoadjuvant chemotherapy followed by interval cytoreductive surgery versus those who received primary cytoreductive surgery. We excluded studies examining only patients with leiomyosarcomas, carcinosarcomas, and stromal sarcomas due to the biologic heterogeneity of these malignancies. Results: The nine included studies encompassed 5,844 patients, of which 1,317 (22.5%) received NACT and 4,527 received PCS (77.5%). With the exception of a single study, all were retrospective observational studies or case series. Use of NACT in patients with stage IV EC increased from 16.0% in 2010 to 23.9% in 2015. Five studies analyzed median overall survival and all but one reported no significant difference between NACT + ICS vs. PCS. Optimal cytoreduction (<1 cm of residual disease) rates were similar across both treatment groups in three separate analyses, however pooled data suggest improved rates of optimal cytoreduction for NACT + ICS vs. PCS patients (81.9% vs. 51.5% respectively). Patients receiving NACT experienced significantly shorter hospital admissions and lower operative times compared to PCS counterparts. Conclusions: NACT followed by ICS reduces perioperative morbidity while offering similar overall survival.Allan B. HuangJenny WuLing ChenBenjamin B. AlbrightRebecca A. PrevisHaley A. MossBrittany A. DavidsonLaura J. HavrileskyAlexander MelamedJason D. WrightElsevierarticleEndometrial cancerUterine cancerHysterectomyNeoadjuvantCytoreductionDebulkingGynecology and obstetricsRG1-991Neoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENGynecologic Oncology Reports, Vol 38, Iss , Pp 100887- (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Endometrial cancer Uterine cancer Hysterectomy Neoadjuvant Cytoreduction Debulking Gynecology and obstetrics RG1-991 Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	Endometrial cancer Uterine cancer Hysterectomy Neoadjuvant Cytoreduction Debulking Gynecology and obstetrics RG1-991 Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Allan B. Huang Jenny Wu Ling Chen Benjamin B. Albright Rebecca A. Previs Haley A. Moss Brittany A. Davidson Laura J. Havrilesky Alexander Melamed Jason D. Wright Neoadjuvant chemotherapy for advanced stage endometrial cancer: A systematic review
description	Objective: While primary cytoreductive surgery (PCS) is considered the standard of care for women who present with stage IV endometrial cancer, neoadjuvant chemotherapy (NACT) followed by interval cytoreductive surgery (ICS) has emerged as an alternative treatment strategy. We summarized the literature and compared outcomes of PCS compared to NACT and ICS. Methods: We conducted a systematic search on PubMed, Embase, Web of Science, and Scopus for articles published from January 1, 1990 to December 31, 2020. Key search terms included multiple descriptors of advanced disease status in combination with “endometrial cancer” and “neoadjuvant chemotherapy”. Our review included studies that examined survival and surgical outcomes of patients with stage III or IV endometrial cancer treated with neoadjuvant chemotherapy followed by interval cytoreductive surgery versus those who received primary cytoreductive surgery. We excluded studies examining only patients with leiomyosarcomas, carcinosarcomas, and stromal sarcomas due to the biologic heterogeneity of these malignancies. Results: The nine included studies encompassed 5,844 patients, of which 1,317 (22.5%) received NACT and 4,527 received PCS (77.5%). With the exception of a single study, all were retrospective observational studies or case series. Use of NACT in patients with stage IV EC increased from 16.0% in 2010 to 23.9% in 2015. Five studies analyzed median overall survival and all but one reported no significant difference between NACT + ICS vs. PCS. Optimal cytoreduction (<1 cm of residual disease) rates were similar across both treatment groups in three separate analyses, however pooled data suggest improved rates of optimal cytoreduction for NACT + ICS vs. PCS patients (81.9% vs. 51.5% respectively). Patients receiving NACT experienced significantly shorter hospital admissions and lower operative times compared to PCS counterparts. Conclusions: NACT followed by ICS reduces perioperative morbidity while offering similar overall survival.
format	article
author	Allan B. Huang Jenny Wu Ling Chen Benjamin B. Albright Rebecca A. Previs Haley A. Moss Brittany A. Davidson Laura J. Havrilesky Alexander Melamed Jason D. Wright
author_facet	Allan B. Huang Jenny Wu Ling Chen Benjamin B. Albright Rebecca A. Previs Haley A. Moss Brittany A. Davidson Laura J. Havrilesky Alexander Melamed Jason D. Wright
author_sort	Allan B. Huang
title	Neoadjuvant chemotherapy for advanced stage endometrial cancer: A systematic review
title_short	Neoadjuvant chemotherapy for advanced stage endometrial cancer: A systematic review
title_full	Neoadjuvant chemotherapy for advanced stage endometrial cancer: A systematic review
title_fullStr	Neoadjuvant chemotherapy for advanced stage endometrial cancer: A systematic review
title_full_unstemmed	Neoadjuvant chemotherapy for advanced stage endometrial cancer: A systematic review
title_sort	neoadjuvant chemotherapy for advanced stage endometrial cancer: a systematic review
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/487cccd14cec469c978d5f218e10b84c
work_keys_str_mv	AT allanbhuang neoadjuvantchemotherapyforadvancedstageendometrialcancerasystematicreview AT jennywu neoadjuvantchemotherapyforadvancedstageendometrialcancerasystematicreview AT lingchen neoadjuvantchemotherapyforadvancedstageendometrialcancerasystematicreview AT benjaminbalbright neoadjuvantchemotherapyforadvancedstageendometrialcancerasystematicreview AT rebeccaaprevis neoadjuvantchemotherapyforadvancedstageendometrialcancerasystematicreview AT haleyamoss neoadjuvantchemotherapyforadvancedstageendometrialcancerasystematicreview AT brittanyadavidson neoadjuvantchemotherapyforadvancedstageendometrialcancerasystematicreview AT laurajhavrilesky neoadjuvantchemotherapyforadvancedstageendometrialcancerasystematicreview AT alexandermelamed neoadjuvantchemotherapyforadvancedstageendometrialcancerasystematicreview AT jasondwright neoadjuvantchemotherapyforadvancedstageendometrialcancerasystematicreview
_version_	1718431227567931392

Neoadjuvant chemotherapy for advanced stage endometrial cancer: A systematic review

Ejemplares similares