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Comparison of the survival outcome of neoadjuvant therapy followed by radical surgery with that of concomitant chemoradiotherapy in patients with stage IB2–IIIB cervical adenocarcinoma

  • Gynecologic Oncology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

To compare the survival outcome of neoadjuvant therapy (NAT) (chemotherapy or chemotherapy and intracavitary brachytherapy (ICBT) followed by radical surgery and of concomitant chemotherapy and radiotherapy (CCRT) in patients with locally advanced cervical adenocarcinoma and identify predictors of cervical adenocarcinoma.

Methods

We retrospectively reviewed our medical records of cervical adenocarcinoma patients treated with either NAT + surgery or CCRT in our institution from January 2013 to December 2017. The patients were treated with two-dimensional radiotherapy or three-dimensional-conformal or intensity-modulated radiotherapy combined with intracavitary brachytherapy. The regimen of concomitant chemotherapy was weekly cisplatin. The neoadjuvant chemotherapy (NACT) was paclitaxel plus cisplatin. The primary end points were overall survival (OS) and progression-free survival (PFS).

Results

We enrolled 121 patients. There were 42 (34.7%) patients in the NAT + surgery group and 79 (65.3%) in the CCRT group. After univariate multivariate analysis, NAT was an independent predictor of OS (p = 0.008) and PFS (p = 0.006). After propensity score matching, the 5-year OS rates in the NAT + surgery and CCRT groups were 25% and 4%, respectively (p = 0.00014), and the 5-year PFS rates were 25% and 4%, respectively (p = 0.00015). Subgroup analysis showed that the 5-year OS and PFS rates in the NACT + surgery and CCRT groups were both 20% and 8%, respectively (p = 0.015).

Conclusion

Compared with CCRT, NAT followed by radical surgery had better OS and PFS in locally advanced cervical adenocarcinoma. In subgroup analysis, OS and PFS were longer for NACT + surgery than for CCRT.

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Availability of data and materials

The data reported in this paper have been deposited in the Open Science Framework (OSF), https://osf.io/x2dtq/files/.

Code availability

R statistical software is free, we can download the software from https://www.r-project.org. code used in this paper is available at https://osf.io/x2dtq/files/.

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Acknowledgements

Thanks for The Third Affiliated Hospital of Kunming Medical University supporting the writing of this manuscript. Thanks to Xudong Gao, Yunhe Ju and **ang Ding for their financial support for this research.

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Authors and Affiliations

  1. Department of Radiation Therapy, The Third Affiliated Hospital of Kunming Medical University, Kunming, 650118, Yunnan, China

    Tian Tian, Xudong Gao, Yunhe Ju, **ang Ding & Yiqin Ai

  2. Department of Radiation Therapy, The Tumor Hospital of Yunnan Province, Kunming, 650118, Yunnan, China

    Yunhe Ju, **ang Ding & Yiqin Ai

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  1. Tian Tian
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  2. Xudong Gao
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  3. Yunhe Ju
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Contributions

TT: project development, data collection, data analysis, manuscript writing. YA: administrative support. XG: financial support. YJ: financial support. XD: financial support.

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Correspondence to Yiqin Ai.

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Institutional review board approval (IRB) of the Third Affiliated Hospital of Kunming Medical University was obtained for this study. This study was conducted in concordance with the Helsinki Declaration.

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Tian, T., Gao, X., Ju, Y. et al. Comparison of the survival outcome of neoadjuvant therapy followed by radical surgery with that of concomitant chemoradiotherapy in patients with stage IB2–IIIB cervical adenocarcinoma. Arch Gynecol Obstet 303, 793–801 (2021). https://doi.org/10.1007/s00404-020-05826-6

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