Abstract
Objective
This paper aimed to discuss the scope of operation and clinical effects for locally advanced cervical cancer (LACC) after concurrent chemoradiotherapy (CCRT).
Methods
We retrospectively reviewed the records of 444 patients with stages IB2–IIB cervical cancer who were divided into two groups whether or not they received CCRT before radical operation in our institute from January 2013 to December 2016. Patients’ characteristics, treatments, and outcomes were analyzed.
Results
The total efficiency (CR + PR) of the CCRT + operation group was 96.2%. Specifically, the CR rate was 9.1%, and the PR rate was 87.1%. The positive rates of cervical deep interstitial infiltration, lymphatic metastasis, and lymphangial infiltration of the operation group were significantly higher than those of the CCRT + operation group (P < 0.05). A total of 24 and 162 patients in the CCRT + operation group and the operation group, respectively, received adjuvant therapy (P < 0.05). The incidence rate of edema of the lower extremity, radiation enteritis, and radiocystitis after postoperative adjuvant radiotherapy in the operation group was significantly higher than that of the CCRT + operation group (P < 0.05). The 5-year survival rates and 5-year progression-free survival (PFS) rates of the CCRT + operation and operation groups were 79.3% versus 64.0% and 68.9% versus 45.2%, respectively (P < 0.05).
Conclusions
Comprehensive treatment that combines CCRT and radical operation to LACC achieves satisfying clinical effects without increasing the occurrence rate of intraoperative and postoperative complications. Moreover, such treatment can improve the 5-year PFS rate and OS rate.
![](http://media.springernature.com/m312/springer-static/image/art%3A10.1007%2Fs10147-019-01585-w/MediaObjects/10147_2019_1585_Fig1_HTML.png)
Similar content being viewed by others
References
Jemal A, Bray F, Center MM et al (2011) Global cancer statistics. Ca Cancer J Clin. 61:69–90
Chuang L, Kanis MJ, Miller B et al (2016) Treating locally advanced cervical cancer with concurrent chemoradiation without brachytherapy in low-resource countries. Am J Clin Oncol. 39:92–97
Li L, Wu M, Ma S et al (2019) Neoadjuvant chemotherapy followed by radical hysterectomy for stage IB2-to-IIB cervical cancer: a retrospective cohort study. Int J Clin Oncol. https://doi.org/10.1007/s10147-019-01510-1
Therasse P, Arbuck SG, Eisenhauer EA et al (2010) New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst. 92:205–216
Wang L, Lu J, Yin J et al (2017) Perspectives on patient access to radiation oncology facilities and services in mainland china. Semin Radiat Oncol. 27:164–168
Wei L, Wang N, Shi M et al (2013) Outcome observation of preoperative concurrent chemoradiotherapy/radiotherapy alone in 174 Chinese patients with local advanced cervical carcinoma. Onco Targets Ther 6:67–74
Wang N, Li W, Li J et al (2014) Comparison of concurrent chemoradiotherapy followed by radical surgery and high-dose-rate intracavitary brachytherapy: a retrospective study of 240 patients with FIGO stage IIB cervical carcinoma. Onco Targets Ther. 7:91–100
Ferrandina G, Ercoli A, Fagotti A et al (2014) Completion surgery after concomitant chemoradiation in locally advanced cervical cancer: a comprehensive analysis of pattern of postoperative complications. Ann Surg Oncol. 21:1692
Lambaudie E, Narducci F, Bannier M et al (2010) Role of robot-assisted laparoscopy in adjuvant surgery for locally advanced cervical cancer. Eur J Surg Oncol. 36:409–413. https://doi.org/10.1016/j.ejso.2009.12.004
Kim TH, Choi CH, Choi JK et al (2014) Robotic versus laparoscopic radical hysterectomy in cervical cancer patients: a matched-case comparative study. Int J Gynecol Cancer 24:1466–1473. https://doi.org/10.1097/IGC.0000000000000232
Motton S, Houvenaeghel G, Delannes M et al (2010) Results of surgery after concurrent chemoradiotherapy in advanced cervical cancer: comparison of extended hysterectomy and extrafascial hysterectomy. Int J Gynecol Cancer. 20:268–275
Robin TP, Amini A, Schefter TE et al (2016) Disparities in standard of care treatment and associated survival decrement in patients with locally advanced cervical cancer. Gynecol Oncol 143:319–325
Anderson KC, Alsina M, Bensinger W et al (2009) NCCN clinical practice guidelines in oncology: multiple myeloma. J Natl Compr Cancer Netw JNCCN 7:908–942
Espenel S, Garcia MA, Trone JC et al (2018) From IB2 to IIIB locally advanced cervical cancers: report of a ten-year experience. Radiat Oncol. 13:16
Vizza E, Pellegrino A, Milani R et al (2011) Total laparoscopic radical hysterectomy and pelvic lymphadenectomy in locally advanced stage IB2–IIB cervical cancer patients after neoadjuvant chemotherapy. Eur J Surg Oncol. 37:364–369. https://doi.org/10.1016/j.ejso.2010.12.001
Leguevaque P, Motton S, Delannes M et al (2011) Completion surgery or not after concurrent chemoradiotherapy for locally advanced cervical cancer? Eur J Obst Gynecol Reprod Biol 155:188–192
Author information
Authors and Affiliations
Contributions
JG and JS performed data collection and drafted the manuscript. JL and BLC designed the study. QZ and XL performed statistical analysis.
Corresponding author
Ethics declarations
Conflict of interest
Authors have no conflict of interest to disclose.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
About this article
Cite this article
Ge, J., Sun, J., Li, J. et al. Operation for locally advanced cervical cancer after concurrent chemoradiotherapy. Int J Clin Oncol 25, 948–954 (2020). https://doi.org/10.1007/s10147-019-01585-w
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10147-019-01585-w