TY - JOUR
T1 - Neoadjuvant Chemotherapy Followed by Radical Surgery versus Concurrent Chemo-Radiotherapy in the Treatment of Locally Advanced Cervical Cancer: A Multicenter Retrospective Analysis
AU - Sala, Paolo
AU - Bogliolo, Stefano
AU - Barra, Fabio
AU - Fazio, Alessandra
AU - Maramai, Mattia
AU - Cassani, Chiara
AU - Gardella, Barbara
AU - Babilonti, Luciana
AU - Giannelli, Flavio
AU - Mammoliti, Serafina
AU - Spinillo, Arsenio
AU - Ferrero, Simone
AU - Valenzano Menada, Mario
AU - Costantini, Sergio
AU - Bruzzi, Paolo
AU - Marchiolè, Pierangelo
N1 - Publisher Copyright:
© 2020 Taylor & Francis Group, LLC.
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020
Y1 - 2020
N2 - 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.
AB - 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.
KW - Cancer
KW - cervical cancer
KW - chemo-radiotherapy
KW - disease-free survival
KW - locally advanced cervical cancer
KW - overall survival
KW - radical surgery
KW - treatment choice
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U2 - 10.1080/08941939.2020.1856239
DO - 10.1080/08941939.2020.1856239
M3 - Article
AN - SCOPUS:85097381528
JO - Journal of Investigative Surgery
JF - Journal of Investigative Surgery
SN - 0894-1939
ER -