Definitive Chemoradiotherapy versus Radical Hysterectomy Followed by Tailored Adjuvant Therapy in Women with Early-Stage Cervical Cancer Presenting with Pelvic Lymph Node Metastasis on Pretreatment Evaluation: A Propensity Score Matching Analysis

To compare the oncologic outcomes between chemoradiotherapy (CRT) and radical hysterectomy followed by tailored adjuvant therapy in patients with early cervical cancer presenting with pelvic lymph node metastasis. We retrospectively analyzed the medical records of women with early cervical cancer pr...

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Bibliographic Details
Published in:Cancers 2021-07, Vol.13 (15), p.3703
Main Authors: Park, Jongmoo, Kim, Yeon-Joo, Song, Mi-Kyung, Nam, Joo-Hyun, Park, Sang-Yoon, Kim, Young-Seok, Kim, Joo-Young
Format: Article
Language:English
Subjects:
Adjuvant therapy
Cancer therapies
Cervical cancer
Chemoradiotherapy
Chemotherapy
Histology
Hysterectomy
Lymph nodes
Lymphatic system
Magnetic resonance imaging
Medical records
Metastases
Metastasis
Multivariate analysis
Patients
Radiation therapy
Statistical analysis
Surgery
Survival
Vagina
Variables
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Summary:To compare the oncologic outcomes between chemoradiotherapy (CRT) and radical hysterectomy followed by tailored adjuvant therapy in patients with early cervical cancer presenting with pelvic lymph node metastasis. We retrospectively analyzed the medical records of women with early cervical cancer presenting with positive pelvic nodes identified on pretreatment imaging assessment. Propensity score matching was employed to control for the heterogeneity between two groups according to confounding factors. Overall survival, disease-free survival, and pattern of failure were compared between the two groups. A total of 262 patients were identified; among them, 67 received definitive CRT (group A), and 195 received hysterectomy (group B). Adjuvant therapy was administered to 88.7% of group B. There were no significant differences between group A and group B regarding the 5-year overall survival rates (89.2% vs. 89.0%) as well as disease-free survival rates (80.6% vs. 82.7%), and patterns of failure. Distant metastasis was the major failure pattern identified in both groups. In multivariate analysis, non-squamous histology was significantly associated with poorer overall survival. As there are no significant differences in 5-year OS, DFS, and patterns of failure, definitive CRT could avoid the combined modality therapy without compromising oncologic outcomes.
ISSN:2072-6694
2072-6694
DOI:10.3390/cancers13153703