Neoadjuvant chemotherapy followed by radical surgery versus concurrent chemoradiotherapy in patients with FIGO stage IIB cervical cancer

2020 ◽  
Vol 159 ◽  
pp. 353
Author(s):  
T. Junying ◽  
H. Jin ◽  
L. Jinjin ◽  
O. Xiping ◽  
L. Pujun ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Concurrent Chemoradiotherapy ◽  
Radical Surgery ◽  
Figo Stage

Neoadjuvant chemotherapy followed by radical surgery versus concurrent chemoradiotherapy in patients with FIGO stage IIB cervical cancer: the CSEM 006 study

2020 ◽  
Vol 31 (1) ◽  
pp. 129-133
Author(s):  
Hua Tu ◽  
He Huang ◽  
Yi Ouyang ◽  
Qing Liu ◽  
Bingna Xian ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Sample Size ◽  
Primary Endpoint ◽  
Concurrent Chemoradiotherapy ◽  
Radical Surgery ◽  
Disease Free Survival ◽  
Squamous Carcinoma ◽  
Figo Stage ◽  
Paraaortic Lymphadenectomy

BackgroundConcurrent chemoradiotherapy is the first-line treatment for FIGO stage IIB cervical cancer. Neoadjuvant chemotherapy followed by radical surgery may provide another treatment option.Primary objectiveTo compare the therapeutic outcomes of neoadjuvant chemotherapy followed by surgery with cisplatin-based concurrent chemoradiotherapy for stage IIB cervical cancer.Study hypothesisWe hypothesize that the therapeutic effect of neoadjuvant chemotherapy combined with surgery and risk-adapted adjuvant treatment will be superior to that of concurrent chemoradiotherapy in stage IIB cervical cancer.Trial designPatients with stage IIB cervical cancer will be randomized 1:1 to neoadjuvant chemotherapy followed by surgery (Arm A) or concurrent chemoradiotherapy (Arm B). In arm A, patients will receive three cycles of paclitaxel and cisplatin followed by a type C radical hysterectomy and pelvic ±paraaortic lymphadenectomy. Patients showing progression after neoadjuvant chemotherapy will be referred to concurrent chemoradiotherapy. Adjuvant therapy will be recommended according to the presence of pathological risks. In Arm B, all patients will receive definitive concurrent chemoradiotherapy, including external beam pelvic radiotherapy combined with concurrent weekly cisplatin followed by brachytherapy.Major inclusion/exclusion criteriaPatients between 18 and 60 years with histologically confirmed, untreated stage IIB cervical squamous carcinoma, adenocarcinoma, or adeno-squamous carcinoma.Primary endpointThe primary endpoint is 2-year disease-free survival.Sample sizeAn estimated sample size of 240 is required to fulfill the study objectives.Estimated dates for completing accrual and presenting resultsAs of February 2020, 115 eligible patients from four institutions have been enrolled. Enrollment is expected to be completed by December 2022.Trial registration numberClinicalTrials. gov identifier: NCT02595554.

scholarly journals Clinical Outcome of Figo 2018 Stage Ib3/Iia2 Cervical Cancer Submitted to Neoadjuvant Chemotherapy Followed by Radical Surgery in Lack of Radiotherapy Equipment: A Retrospective Comparison with Concurrent Chemoradiotherapy

2021 ◽  
Vol 4 (1) ◽  
Keyword(s):  
Cervical Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Concurrent Chemoradiotherapy ◽  
Radical Surgery ◽  
Study Groups ◽  
Figo Stage ◽  
Late Complications ◽  
Clinicopathologic Characteristics ◽  
Significant Difference ◽  
Characteristics Analysis

Purpose: To compare the clinical outcomes between concurrent chemoradiotherapy (CCRT) and neoadjuvant chemotherapy followed by radical surgery ((NACT-RS) among patients with cervical cancer stage IB3 and IIA2. Methods: The study retrospectively reviewed patients with (2018 FIGO) stage IB3 and IIA2 cervical cancer. The patients received either preoperative neoadjuvant chemotherapy, followed by NACT-RS or CCRT. The outcome measures were the 5-year survival and complication rate between the two groups. Results: The median follow-up was 75 months. In total, 218 patients had stage IIA2, 136 patients had stage IB3, 201 patients received CCRT, and 153 patients received preoperative NACT-RS. In the CCRT group, the incidence of early complications (Myelosuppression, gastrointestinal and urinary) was higher compared with that in the NACT-RS group (76.1 vs. 26.1%, p <0.001; respectively). However, there was no significant difference between the two study groups concerning late complications. Five-year PFS was 79.9% and 85.5% in the NACT-RS and CCRT groups, respectively (p = 0.093). Five-year OS was 86.9% and 85.5% in the NACT-RS and CCRT groups, respectively (p = 0.97). In the multivariate clinicopathologic characteristics analysis for OS, initial tumor size >4.3 cm (HR, 5.11; p<0.001), AC/ASC (HR, 1.89; p = 0.02), histologic grade 2-3 (HR, 2.25; p = 0.04), and 2018 FIGO stage IIA2 (HR, 8.67; p<0.001) were independent risk factors. Conclusions: The survival of patients with stage IB3 and IIA2 cervical cancer treated with NACT-RS was similar to that of patients treated with CCRT without increasing side effects.

Effects of Neoadjuvant Chemotherapy Plus Radical Surgery as Front Line Treatment Strategy in Patients Affected by FIGO Stage III Cervical Cancer

2016 ◽  
Vol 23 (S5) ◽  
pp. 841-849 ◽  
Author(s):  
Violante Di Donato ◽  
Michele Carlo Schiavi ◽  
Ilary Ruscito ◽  
Virginia Sibilla Visentin ◽  
Innocenza Palaia ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Treatment Strategy ◽  
Radical Surgery ◽  
Figo Stage ◽  
Stage Iii ◽  
Line Treatment ◽  
Front Line

scholarly journals Effect of neoadjuvant chemotherapy followed by radical surgery for FIGO stage IB2/IIA2 cervical cancer

Medicine ◽  
2019 ◽  
Vol 98 (21) ◽  
pp. e15604 ◽  
Author(s):  
Hui Zhao ◽  
Yue He ◽  
Li-Rong Zhu ◽  
Jian-Liu Wang ◽  
Hong-Yan Guo ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Radical Surgery ◽  
Figo Stage

scholarly journals Effect of neoadjuvant chemotherapy followed by surgery for FIGO stage I–II cervical cancer: a meta-analysis

2020 ◽  
Vol 48 (8) ◽  
pp. 030006052094550
Author(s):  
Shu-Li Yang ◽  
Ling Chen ◽  
Yue He ◽  
Hui Zhao ◽  
Yu-Mei Wu
Keyword(s):  
Cervical Cancer ◽  
Survival Rate ◽  
Neoadjuvant Chemotherapy ◽  
Radical Surgery ◽  
Meta Analysis ◽  
Locally Advanced ◽  
Figo Stage ◽  
Stage I ◽  
Oncological Outcomes ◽  
Gynecology And Obstetrics

Objective In this meta-analysis, we aimed to evaluate the oncological outcomes of preoperative neoadjuvant chemotherapy followed by radical surgery compared with radical surgery alone for treatment of International Federation of Gynecology and Obstetrics (FIGO) stage I–II cervical cancer. Method We searched for studies comparing the safety and efficacy of neoadjuvant chemotherapy plus surgery versus surgery alone in treatment outcomes of locally advanced cervical cancer. Meta-analysis was used to calculate the pooled odds ratios with corresponding 95% confidence intervals (CI). Results Sixteen studies were included in our analysis. Pooled analysis of overall survival rate [odds ratio (OR) = 1.09, 95% CI: 0.83–1.43] and progression-free survival rate (OR = 1.10, 95% CI: 0.77–1.57) showed that preoperative neoadjuvant chemotherapy did not have a benefit compared with surgery alone in terms of survival rates. The pooled results for postoperative parameters indicated that preoperative neoadjuvant chemotherapy followed by radical surgery was associated with a high rate of vascular space involvement (OR = 0.25, 95% CI: 0.17–0.35) and parametrial infiltration (OR = 0.60, 95% CI: 0.45–0.79). Conclusions This meta-analysis indicated that surgery following neoadjuvant chemotherapy for FIGO stage I–II cervical cancer and surgery alone had similar oncological outcomes.

Neoadjuvant Chemotherapy Followed by Radical Surgery in Patients Affected by FIGO Stage IVA Cervical Cancer

2007 ◽  
Vol 14 (9) ◽  
pp. 2643-2648 ◽  
Author(s):  
Pierluigi Benedetti Panici ◽  
Filippo Bellati ◽  
Natalina Manci ◽  
Milena Pernice ◽  
Francesco Plotti ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Radical Surgery ◽  
Figo Stage

Is salvage radiotherapy optimal to patients with occult cervical cancer undergoing inadvertent simple hysterectomy? A propensity score-matched analysis of a nationwide clinical oncology database

2021 ◽  
Author(s):  
Yanhong Wang ◽  
Yi Ouyang ◽  
Jingjing Su ◽  
Lihua Xiao ◽  
Zhigang Bai ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Overall Survival ◽  
Propensity Score ◽  
Radical Surgery ◽  
Figo Stage ◽  
Salvage Radiotherapy ◽  
Radiotherapy Group ◽  
Surgery Group ◽  
Group Matching

Abstract Objective We used National Cancer Institute’s Surveillance, Epidemiology and End Result database to assess the role of salvage radiotherapy for women with unanticipated cervical cancer after simple hysterectomy. Methods Patients with non-metastatic cervical cancer and meeting inclusion criteria were divided into three groups based on treatment strategy: simple hysterectomy, salvage radiotherapy after hysterectomy and radical surgery. Parallel propensity score-matched datasets were established for salvage radiotherapy group vs. simple hysterectomy group (matching ratio 1: 1), and salvage radiotherapy group vs. radical surgery group (matching ratio 1:2). The primary endpoint was the overall survival advantage of salvage radiotherapy over simple hysterectomy or radical surgery within the propensity score-matched datasets. Results In total, 2682 patients were recruited: 647 in the simple hysterectomy group, 564 in the salvage radiotherapy group and 1471 in the radical surgery group. Age, race, histology, grade, FIGO stage, insured and marital status and chemotherapy were comprised in propensity score-matched. Matching resulted in two comparison groups with neglectable differences in most variables, except for black race, FIGO stage III and chemotherapy in first matching. In the matched analysis for salvage radiotherapy vs. simple hysterectomy, the median follow-up time was 39 versus 32 months. In the matched analysis for salvage radiotherapy vs. radical surgery, the median follow-up time was 39 and 41 months, respectively. Salvage radiotherapy (HR 0.53, P = 0.046) significantly improved overall survival compared with simple hysterectomy, while salvage radiotherapy cannot achieve similar overall survival to radical surgery (HR 1.317, P = 0.045). Conclusions This is the largest study of the effect of salvage radiotherapy on overall survival in patients with unanticipated cervical cancer. Salvage radiotherapy can improve overall survival compared with hysterectomy alone, while cannot achieve comparable survival to radical surgery.

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