|
KMID : 1137020220330020014
|
|
Journal of Gynecologic Oncology
2022 Volume.33 No. 2 p.14 ~ p.14
|
|
|
Comparison of treatment outcomes of surgery and radiotherapy, including concurrent chemoradiotherapy for stage Ib2-IIb cervical adenocarcinoma patients: a retrospective study
|
|
Kondo Eiji
Yoshida Kenta
Tabata Tsutomu
Kobayashi Yoichi
Yamagami Wataru
Ebina Yasuhiko
Kaneuchi Masanori
Nagase Satoru
Machida Hiroko
Mikami Mikio
|
|
|
Abstract
|
|
|
Objective: The study compared the treatment outcomes of surgery versus radiotherapy, including concurrent chemoradiotherapy, in stage Ib2?IIb cervical adenocarcinoma patients in Japan.
Methods: Of 57,470 patients diagnosed with stage I?IV cervical cancer from January 2001?December 2011, 1,932 patients with stage Ib2?IIb cervical adenocarcinoma were initially treated by surgery or radiotherapy. The primary endpoint was 5-year overall survival (OS) in all and 614 propensity score-matched (PSM) patients (307 per group). We compared OS and prognosis factors based on age, primary stage, and treatment arm.
Results: In Japan, >80% (n=1,573) of stage Ib2?IIb cervical adenocarcinoma patients underwent surgery. The 5-year OS of surgery vs. radiotherapy groups were 82.1% (n=704) vs. 79.7% (n=59) (hazard ratio [HR]=1.494; 95% confidence interval [CI]=0.826?2.702; p=0.181) for stage Ib2, 76.6% (n=239) vs. 66.7% (n=54) (HR=1.679; 95% CI=0.986?2.858; p=0.053) for stage IIa, and 71.1% (n=630) vs. 58.9% (n=246) (HR=1.711; 95% CI=1.341?2.184; p<0.001) for stage IIb. In 614 PSM patients balanced for age and carcinoma stage Ib2?IIb, the 5-year OS of surgery vs. radiation groups was 73.0% (n=307) vs. 65.5% (n=307) (HR=1.394; 95% CI=1.044?1.860; p=0.023). In multivariable analysis, age (HR=1.293; 95% CI=1.045?1.601; p=0.018), treatment arm, radiotherapy (HR=1.556; 95% CI=1.253?1.933; p<0.001), and stage IIb (HR=1.783; 95% CI=1.443?2.203; p=0.018) were independent prognosis factors for 5-year OS in stage Ib2?IIb adenocarcinoma patients.
Conclusion: Age (>65 years), treatment arm (radiotherapy), and stage IIb significantly affect OS in cervical adenocarcinoma patients. Surgery may be considered for <65-year-old patients with stage IIb adenocarcinoma.
|
|
|
KEYWORD
|
|
|
Adenocarcinoma, Cervical Cancer, Radiotherapy, Survival Rate, Treatment Outcome
|
|
|
FullTexts / Linksout information
|
|
|
|
|
|
Listed journal information
|
|
    
|
|