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

Abstract Background To determine whether additional chemotherapy after concurrent chemoradiation (CCRT) improves survival outcomes in patients with early cervical cancer who undergo radical hysterectomy (RH). Methods We included high- or intermediate-risk patients from two institutions, with 2009 FI...

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Autores principales:	Se Ik Kim, Jeong Yun Kim, Chan Woo Wee, Maria Lee, Hee Seung Kim, Hyun Hoon Chung, Taek Sang Lee, Hye Won Jeon, Noh Hyun Park, Yong Sang Song, Tae Hun Kim
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Uterine cervical neoplasms Hysterectomy Chemoradiotherapy Chemotherapy, adjuvant Prognosis Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/9bfc87480adb44819afa159b6ce9e9f9
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spelling	oai:doaj.org-article:9bfc87480adb44819afa159b6ce9e9f92021-11-28T12:27:23ZSurvival impact of additional chemotherapy after adjuvant concurrent chemoradiation in patients with early cervical cancer who underwent radical hysterectomy10.1186/s12885-021-08940-z1471-2407https://doaj.org/article/9bfc87480adb44819afa159b6ce9e9f92021-11-01T00:00:00Zhttps://doi.org/10.1186/s12885-021-08940-zhttps://doaj.org/toc/1471-2407Abstract Background To determine whether additional chemotherapy after concurrent chemoradiation (CCRT) improves survival outcomes in patients with early cervical cancer who undergo radical hysterectomy (RH). Methods We 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). Results A 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). Conclusions Additional chemotherapy after CCRT might not improve survival outcomes in patients with early cervical cancer who undergo RH.Se Ik KimJeong Yun KimChan Woo WeeMaria LeeHee Seung KimHyun Hoon ChungTaek Sang LeeHye Won JeonNoh Hyun ParkYong Sang SongTae Hun KimBMCarticleUterine cervical neoplasmsHysterectomyChemoradiotherapyChemotherapy, adjuvantPrognosisNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENBMC Cancer, Vol 21, Iss 1, Pp 1-13 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Uterine cervical neoplasms Hysterectomy Chemoradiotherapy Chemotherapy, adjuvant Prognosis Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	Uterine cervical neoplasms Hysterectomy Chemoradiotherapy Chemotherapy, adjuvant Prognosis Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Se Ik Kim Jeong Yun Kim Chan Woo Wee Maria Lee Hee Seung Kim Hyun Hoon Chung Taek Sang Lee Hye Won Jeon Noh Hyun Park Yong Sang Song Tae Hun Kim Survival impact of additional chemotherapy after adjuvant concurrent chemoradiation in patients with early cervical cancer who underwent radical hysterectomy
description	Abstract Background To determine whether additional chemotherapy after concurrent chemoradiation (CCRT) improves survival outcomes in patients with early cervical cancer who undergo radical hysterectomy (RH). Methods We 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). Results A 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). Conclusions Additional chemotherapy after CCRT might not improve survival outcomes in patients with early cervical cancer who undergo RH.
format	article
author	Se Ik Kim Jeong Yun Kim Chan Woo Wee Maria Lee Hee Seung Kim Hyun Hoon Chung Taek Sang Lee Hye Won Jeon Noh Hyun Park Yong Sang Song Tae Hun Kim
author_facet	Se Ik Kim Jeong Yun Kim Chan Woo Wee Maria Lee Hee Seung Kim Hyun Hoon Chung Taek Sang Lee Hye Won Jeon Noh Hyun Park Yong Sang Song Tae Hun Kim
author_sort	Se Ik Kim
title	Survival impact of additional chemotherapy after adjuvant concurrent chemoradiation in patients with early cervical cancer who underwent radical hysterectomy
title_short	Survival impact of additional chemotherapy after adjuvant concurrent chemoradiation in patients with early cervical cancer who underwent radical hysterectomy
title_full	Survival impact of additional chemotherapy after adjuvant concurrent chemoradiation in patients with early cervical cancer who underwent radical hysterectomy
title_fullStr	Survival impact of additional chemotherapy after adjuvant concurrent chemoradiation in patients with early cervical cancer who underwent radical hysterectomy
title_full_unstemmed	Survival impact of additional chemotherapy after adjuvant concurrent chemoradiation in patients with early cervical cancer who underwent radical hysterectomy
title_sort	survival impact of additional chemotherapy after adjuvant concurrent chemoradiation in patients with early cervical cancer who underwent radical hysterectomy
publisher	BMC
publishDate	2021
url	https://doaj.org/article/9bfc87480adb44819afa159b6ce9e9f9
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Survival impact of additional chemotherapy after adjuvant concurrent chemoradiation in patients with early cervical cancer who underwent radical hysterectomy

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