Abdominal Radical Hysterectomy as an Alternative Treatment Option for Patients with Cervical Cancer without Access to Radiotherapy Facilities
Background: To compare the oncological outcomes of Chinese patients with International Federation of Gynecology and Obstetrics (FIGO) 2018 stage IIIC cervical cancer (CC) receiving radical chemoradiotherapy (R-CT), abdominal radical hysterectomy (ARH), or neoadjuvant chemotherapy and radical surgery...
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IMR Press
2023-10-01
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| Series: | Clinical and Experimental Obstetrics & Gynecology |
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| Online Access: | https://www.imrpress.com/journal/CEOG/50/10/10.31083/j.ceog5010219 |
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| author | Yanna Ye Zhiqiang Li Biliang Chen Shan Kang Bin Ling Li Wang Jilong Yao Jinghe Lan Ping Liu Chunlin Chen |
| author_facet | Yanna Ye Zhiqiang Li Biliang Chen Shan Kang Bin Ling Li Wang Jilong Yao Jinghe Lan Ping Liu Chunlin Chen |
| author_sort | Yanna Ye |
| collection | DOAJ |
| description | Background: To compare the oncological outcomes of Chinese patients with International Federation of Gynecology and Obstetrics (FIGO) 2018 stage IIIC cervical cancer (CC) receiving radical chemoradiotherapy (R-CT), abdominal radical hysterectomy (ARH), or neoadjuvant chemotherapy and radical surgery (NACT). Methods: Overall, 4086 patients in 47 hospitals from 2004 to 2018 were divided into groups according to stage (4029 with stage IIIC1 and 57 with stage IIIC2). Kaplan-Meier and Cox regression analyses were applied to compare the 5-year overall survival (OS) and disease-free survival (DFS) of the three initial treatments before and after propensity score matching (PSM). Results: The 5-year DFS was worse in patients with stage IIIC2 than in those with stage IIIC1 (post-PSM: 68.3% vs. 39.9%, p < 0.001). For stage IIIC1, the ARH group had better 5-year OS (post-PSM: 71.0% vs. 80.0%, p < 0.001) and DFS (post-PSM: 67.2% vs. 71.0%, p < 0.001) than the R-CT group, while the NACT group had worse 5-year DFS (post-PSM: 67.7% vs. 55.3%, p = 0.002). The 5-year OS (post-PSM: 80.9% vs. 70.5%, p < 0.001) and DFS (post-PSM: 70.7% vs. 54.1%, p < 0.001) were better in the ARH than in the NACT group. For stage IIIC2, the 5-year DFS was better in the ARH than in the NACT group (45.4% vs. 30.1%, p = 0.025). Conclusions: The oncological prognosis of patients with stage IIIC1 CC was generally better than that of patients with stage IIIC2, thereby supporting the rationale behind the classification of stage IIIC. In less developed areas, the ARH is a promising alternative treatment option for patients with stage IIIC; nonetheless, the use of NACT is not advisable. Clinical Trial Registration: The study was registered at http://apps.who.int/trialsearch/, registration number CHiCTR1800017778. |
| format | Article |
| id | doaj-art-5e0ad87138b943e6a7ab5640deed31bb |
| institution | DOAJ |
| issn | 0390-6663 |
| language | English |
| publishDate | 2023-10-01 |
| publisher | IMR Press |
| record_format | Article |
| series | Clinical and Experimental Obstetrics & Gynecology |
| spelling | doaj-art-5e0ad87138b943e6a7ab5640deed31bb2025-08-20T03:18:08ZengIMR PressClinical and Experimental Obstetrics & Gynecology0390-66632023-10-01501021910.31083/j.ceog5010219S0390-6663(23)02136-XAbdominal Radical Hysterectomy as an Alternative Treatment Option for Patients with Cervical Cancer without Access to Radiotherapy FacilitiesYanna Ye0Zhiqiang Li1Biliang Chen2Shan Kang3Bin Ling4Li Wang5Jilong Yao6Jinghe Lan7Ping Liu8Chunlin Chen9Department of Midwifery, Faculty of Health, Dongguan Polytechnic, 523808 Dongguan, Guangdong, ChinaDepartment of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, 510515 Guangzhou, Guangdong, ChinaDepartment of Obstetrics and Gynecology, Xijing Hospital of Airforce Medical University, 710032 Xi'an, Shanxi, ChinaDepartment of Gynecology, Fourth Hospital, Hebei Medical University, 050019 Shijiazhuang, Hebei, ChinaDepartment of Obstetrics and Gynecology, China-Japan Friendship Hospital, 100029 Beijing, ChinaDepartment of Gynecologic Oncology, Affiliated Cancer Hospital, Zhengzhou University, 450008 Zhengzhou, Henan, ChinaDepartment of Obstetrics and Gynecology, Shenzhen Maternal and Child Health Hospital, 518028 Shenzhen, Guangdong, ChinaDepartment of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, 510515 Guangzhou, Guangdong, ChinaDepartment of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, 510515 Guangzhou, Guangdong, ChinaDepartment of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, 510515 Guangzhou, Guangdong, ChinaBackground: To compare the oncological outcomes of Chinese patients with International Federation of Gynecology and Obstetrics (FIGO) 2018 stage IIIC cervical cancer (CC) receiving radical chemoradiotherapy (R-CT), abdominal radical hysterectomy (ARH), or neoadjuvant chemotherapy and radical surgery (NACT). Methods: Overall, 4086 patients in 47 hospitals from 2004 to 2018 were divided into groups according to stage (4029 with stage IIIC1 and 57 with stage IIIC2). Kaplan-Meier and Cox regression analyses were applied to compare the 5-year overall survival (OS) and disease-free survival (DFS) of the three initial treatments before and after propensity score matching (PSM). Results: The 5-year DFS was worse in patients with stage IIIC2 than in those with stage IIIC1 (post-PSM: 68.3% vs. 39.9%, p < 0.001). For stage IIIC1, the ARH group had better 5-year OS (post-PSM: 71.0% vs. 80.0%, p < 0.001) and DFS (post-PSM: 67.2% vs. 71.0%, p < 0.001) than the R-CT group, while the NACT group had worse 5-year DFS (post-PSM: 67.7% vs. 55.3%, p = 0.002). The 5-year OS (post-PSM: 80.9% vs. 70.5%, p < 0.001) and DFS (post-PSM: 70.7% vs. 54.1%, p < 0.001) were better in the ARH than in the NACT group. For stage IIIC2, the 5-year DFS was better in the ARH than in the NACT group (45.4% vs. 30.1%, p = 0.025). Conclusions: The oncological prognosis of patients with stage IIIC1 CC was generally better than that of patients with stage IIIC2, thereby supporting the rationale behind the classification of stage IIIC. In less developed areas, the ARH is a promising alternative treatment option for patients with stage IIIC; nonetheless, the use of NACT is not advisable. Clinical Trial Registration: The study was registered at http://apps.who.int/trialsearch/, registration number CHiCTR1800017778.https://www.imrpress.com/journal/CEOG/50/10/10.31083/j.ceog5010219figo 2018 iiiccervical cancerradiotherapyprognosisabdominal radical hysterectomy |
| spellingShingle | Yanna Ye Zhiqiang Li Biliang Chen Shan Kang Bin Ling Li Wang Jilong Yao Jinghe Lan Ping Liu Chunlin Chen Abdominal Radical Hysterectomy as an Alternative Treatment Option for Patients with Cervical Cancer without Access to Radiotherapy Facilities Clinical and Experimental Obstetrics & Gynecology figo 2018 iiic cervical cancer radiotherapy prognosis abdominal radical hysterectomy |
| title | Abdominal Radical Hysterectomy as an Alternative Treatment Option for Patients with Cervical Cancer without Access to Radiotherapy Facilities |
| title_full | Abdominal Radical Hysterectomy as an Alternative Treatment Option for Patients with Cervical Cancer without Access to Radiotherapy Facilities |
| title_fullStr | Abdominal Radical Hysterectomy as an Alternative Treatment Option for Patients with Cervical Cancer without Access to Radiotherapy Facilities |
| title_full_unstemmed | Abdominal Radical Hysterectomy as an Alternative Treatment Option for Patients with Cervical Cancer without Access to Radiotherapy Facilities |
| title_short | Abdominal Radical Hysterectomy as an Alternative Treatment Option for Patients with Cervical Cancer without Access to Radiotherapy Facilities |
| title_sort | abdominal radical hysterectomy as an alternative treatment option for patients with cervical cancer without access to radiotherapy facilities |
| topic | figo 2018 iiic cervical cancer radiotherapy prognosis abdominal radical hysterectomy |
| url | https://www.imrpress.com/journal/CEOG/50/10/10.31083/j.ceog5010219 |
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