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KMID : 1137020200310010008
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Journal of Gynecologic Oncology
2020 Volume.31 No. 1 p.8 ~ p.8
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Surgery of primary sites for stage IVB cervical cancer patients receiving chemoradiotherapy: a population-based study
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Li Haoran
Pang Yangyang
Cheng Xi
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Abstract
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Objective: The purpose of this study was to analyze the impact of surgery of primary sites on stage IVB cervical cancer patients from a population-based database, the Surveillance, Epidemiology and End Results (SEER).
Methods: Propensity score matching was performed to minimize heterogeneity in patient between with-surgery group and without-surgery group. Clinicopathological characteristics were compared using the χ2 or Fisher's exact test. Survival analysis included the Kaplan-Meier method, log-rank test, and Cox proportional hazards model.
Results: Between 2010-2015, a total of 1,139 International Federation of Gynecology and Obstetrics (FIGO) stage IVB cervical cancer patients receiving chemoradiotherapy (CRT) were included in this retrospective study. Within post-matching cohort, the median duration of overall survival (OS) in stage IVB cervical cancer patients receiving CRT was 22 months. The overall 5-year survival rate was 25.7%. The increasing American Joint Committee on Cancer T stage (T1 vs. T2, p=0.033, hazard ratio [HR]=1.79, 95% confidence interval [CI]=1.05?3.05; T1 vs. T3, p=0.003, HR=2.20, 95% CI=1.31?3.67; T1 vs. T4, p=0.037, HR=2.75, 95% CI=1.06?7.12) and visceral metastasis (with vs. without, p=0.038, HR=1.60, 95% CI=1.03?2.49) was reported as independent risk factors of OS. Surgery of primary sites combined with CRT tended to prolong the survival of stage IVB cervical cancer patients (p<0.001, HR=0.36, 95% CI=0.21?0.61) compared with CRT, especially for patients without visceral metastasis (p=0.005, HR=0.31, 95% CI=0.14?0.70).
Conclusions: In conclusion, patients with stage IVB cervical cancer may achieve their best outcomes through CRT combined with surgery of primary sites. However, it deserves large scale prospective clinical trials to confirm.
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KEYWORD
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Cervical Cancer, Metastatic, Chemoradiotherapy, Surgery
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