Neoadjuvant Chemotherapy Followed by Radical Surgery versus Concurrent Chemo-Radiotherapy in the Treatment of Locally Advanced Cervical Cancer: A Multicenter Retrospective Analysis

Paolo Sala, Stefano Bogliolo, Fabio Barra, Alessandra Fazio, Mattia Maramai, Chiara Cassani, Barbara Gardella, Luciana Babilonti, Flavio Giannelli, Serafina Mammoliti, Arsenio Spinillo, Simone Ferrero, Mario Valenzano Menada, Sergio Costantini, Paolo Bruzzi, Pierangelo Marchiolè

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: This study aims to evaluate oncological outcomes in women affected by locally advanced cervical cancer (LACC) treated by neoadjuvant chemotherapy before radical surgery (NACT + RS) or concurrent chemo-radiotherapy (CCRT). Methods: This was a multicenter retrospective analysis of data related to women with LACC (FIGO stage IB2-IVA), who were treated by NACT + RS or CCRT between November 2006 and January 2018. The first endpoints were the evaluation of disease-free survival (DFS) and overall survival (OS); univariate and multivariate analyses were performed for identifying the prognostic factors independently associated with these oncological outcomes. Results: Overall, 106 women were included in the analysis; 55 of them (51.9%) underwent NACT + RS and 51 (48.1%) CCRT, respectively. Patients in the NACT + RS group had a significant better five-year DFS and five-year OS than those in the CCRT group (77.4% vs. 33.4%, p <.001 and 93.8% vs. 56.5%, p =.003). In the multivariate analyses, treatment choice (NACT + RS or CCRT) was the only independent prognostic factor for predicting both DFS (HR = 3.954; 95 CI = 1.898–8.236; p < 0.001) and OS (HR = 5.330; 95 CI = 1.563–18.178; p = 0.008). Conclusions: This retrospective study demonstrated an improved survival outcome for patients undergoing NACT + RS compared with those undergoing CCRT. Our findings seem to support the use of NACT before RS as an effective alternative option to CCRT standard therapy.

Original languageEnglish
JournalJournal of Investigative Surgery
DOIs
Publication statusAccepted/In press - 2020

Keywords

  • Cancer
  • cervical cancer
  • chemo-radiotherapy
  • disease-free survival
  • locally advanced cervical cancer
  • overall survival
  • radical surgery
  • treatment choice

ASJC Scopus subject areas

  • Surgery

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