Initial treatment for FIGO 2018 stage IIIC cervical cancer based on histological type : A 14-year multicenter study
© 2023 The Authors. Cancer Medicine published by John Wiley & Sons Ltd..
BACKGROUND: To compare the oncological outcomes of radical chemotherapy (R-CT), abdominal radical hysterectomy (ARH), and neoadjuvant chemotherapy and radical surgery (NACT) for International Federation of Gynecology and Obstetrics (FIGO) 2018 stage IIIC cervical cancer, according to histological types: squamous cell carcinoma (SCC) and adenocarcinoma (AC)/adenosquamous cell carcinoma (ASC).
METHODS: A comparison of 5-year overall survival (OS) and disease-free survival (DFS) was performed for the SCC and AC/ASC subgroups for the three initial treatments, assessed using Kaplan-Meier and Cox proportional hazards regression analysis and validated using propensity score matching (PSM).
RESULTS: The study included 4086 patients: R-CT, n = 1913; ARH, n = 1529; and NACT, n = 644. AC/ASC had a lower survival rate (63.7%) than SCC (73.6%) and a higher recurrence and mortality rate (36.3% and 26.4%, respectively). The 5-year OS and DFS rates were different in the SCC group for R-CT, ARH, and NACT (OS: 69.8% vs. 80.8% vs. 73.0%, p < 0.001; DFS: 66.7% vs. 70.7% vs. 56.4%, p < 0.001), also in the AC/ASC group (OS: 46.1% vs. 70.6% vs. 55.6%, p < 0.001; DFS: 42.7% vs. 64.6% vs. 40.8%, p < 0.001). As for initial treatment, survival outcomes were worse for AC/ASC treated with R-CT and ARH than for SCC (both p < 0.05), with no group differences between the two treated with NACT.
CONCLUSION: Initial treatment influences oncological prognosis for patients with FIGO 2018 stage IIIC cervical cancer. ARH is an alternative treatment for stage IIIC cervical SCC and AC/ASC, and NACT needs to be chosen with caution, moreover, R-CT for AC/ASC requires careful selection.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:12 |
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| Enthalten in: |
Cancer medicine - 12(2023), 19 vom: 31. Okt., Seite 19617-19632 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Ye, Yanna [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 23.10.2023 Date Revised 03.11.2023 published: Print-Electronic ChiCTR: CHiCTR1800017778 Citation Status MEDLINE |
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| doi: |
10.1002/cam4.6586 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 100 | 1 | |a Ye, Yanna |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Initial treatment for FIGO 2018 stage IIIC cervical cancer based on histological type |b A 14-year multicenter study |
| 264 | 1 | |c 2023 | |
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| 500 | |a Date Revised 03.11.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a ChiCTR: CHiCTR1800017778 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2023 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. | ||
| 520 | |a BACKGROUND: To compare the oncological outcomes of radical chemotherapy (R-CT), abdominal radical hysterectomy (ARH), and neoadjuvant chemotherapy and radical surgery (NACT) for International Federation of Gynecology and Obstetrics (FIGO) 2018 stage IIIC cervical cancer, according to histological types: squamous cell carcinoma (SCC) and adenocarcinoma (AC)/adenosquamous cell carcinoma (ASC) | ||
| 520 | |a METHODS: A comparison of 5-year overall survival (OS) and disease-free survival (DFS) was performed for the SCC and AC/ASC subgroups for the three initial treatments, assessed using Kaplan-Meier and Cox proportional hazards regression analysis and validated using propensity score matching (PSM) | ||
| 520 | |a RESULTS: The study included 4086 patients: R-CT, n = 1913; ARH, n = 1529; and NACT, n = 644. AC/ASC had a lower survival rate (63.7%) than SCC (73.6%) and a higher recurrence and mortality rate (36.3% and 26.4%, respectively). The 5-year OS and DFS rates were different in the SCC group for R-CT, ARH, and NACT (OS: 69.8% vs. 80.8% vs. 73.0%, p < 0.001; DFS: 66.7% vs. 70.7% vs. 56.4%, p < 0.001), also in the AC/ASC group (OS: 46.1% vs. 70.6% vs. 55.6%, p < 0.001; DFS: 42.7% vs. 64.6% vs. 40.8%, p < 0.001). As for initial treatment, survival outcomes were worse for AC/ASC treated with R-CT and ARH than for SCC (both p < 0.05), with no group differences between the two treated with NACT | ||
| 520 | |a CONCLUSION: Initial treatment influences oncological prognosis for patients with FIGO 2018 stage IIIC cervical cancer. ARH is an alternative treatment for stage IIIC cervical SCC and AC/ASC, and NACT needs to be chosen with caution, moreover, R-CT for AC/ASC requires careful selection | ||
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a adenocarcinoma/adenosquamous cell carcinoma | |
| 650 | 4 | |a cervical cancer | |
| 650 | 4 | |a cervical cancer treatment | |
| 650 | 4 | |a squamous cell carcinoma | |
| 650 | 4 | |a stage IIIC cervical cancer | |
| 700 | 1 | |a Zhang, Guochao |e verfasserin |4 aut | |
| 700 | 1 | |a Li, Zhiqiang |e verfasserin |4 aut | |
| 700 | 1 | |a Chen, Biliang |e verfasserin |4 aut | |
| 700 | 1 | |a Zhao, Hongwei |e verfasserin |4 aut | |
| 700 | 1 | |a Yang, Ying |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Li |e verfasserin |4 aut | |
| 700 | 1 | |a Yao, Jilong |e verfasserin |4 aut | |
| 700 | 1 | |a Chen, Xiaolin |e verfasserin |4 aut | |
| 700 | 1 | |a Huang, Yahong |e verfasserin |4 aut | |
| 700 | 1 | |a Lang, Jinghe |e verfasserin |4 aut | |
| 700 | 1 | |a Liu, Ping |e verfasserin |4 aut | |
| 700 | 1 | |a Chen, Chunlin |e verfasserin |4 aut | |
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