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. 2015 Sep 15;8(9):14693-700.
eCollection 2015.

The safety and efficacy of the preoperative neoadjuvant chemotherapy for patients with cervical cancer: a systematic review and meta analysis

Du He  1 , Chunyan Duan  1 , Jun Chen  1 , Lin Lai  1 , Jiaquan Chen  1 , Dian Chen  1
Affiliations

The safety and efficacy of the preoperative neoadjuvant chemotherapy for patients with cervical cancer: a systematic review and meta analysis

Du He et al. Int J Clin Exp Med. .

Abstract

Objective: To evaluate the safety and efficacy of the preoperative neoadjuvant chemotherapy for patients with cervical cancer.

Methods: A systematic literature search was conducted using the PubMed, EMBASE and Cochrane databases. Studies comparing combined neoadjuvant chemotherapy treatment (NACT)/radical surgery treatment (RST) with RST alone in patients with cervical cancer were eligible for inclusion.

Results: Eight studies were finally included in this meta analysis, involving a total of 1302 patients. Meta analysis shows that NACT might have lower lymph node metastasis than RST [OR=0.57, 95% CI (0.41, 0.79), P=0.0008]. However, there are no differentiation between two groups in operation time [SMD=0.16, 95% CI (-0.08, 0.48), P=0.19], intraoperative estimated blood loss [SMD=0.20, 95% CI (-0.19, 0.58), P=0.48], intraoperative and postoperative complication rates [OR=1.33, 95% CI (0.45, 3.92), P=0.60], overall survival rate [OR=1.07, 95% CI (0.48, 2.41), P=0.86] and recurrence rate [OR=1.06, 95% CI (0.56, 2.03), P=0.85].

Conclusions: The safety and efficacy of two treatments are similarly. However, NACT can reduce the rate of lymph node metastasis, which is an independent risk factor for cervical cancer prognosis and may improve the prognosis of cervical cancer.

Keywords: Cervical cancer; NACT; RST; meta analysis; preoperative neoadjuvant chemotherapy; radical surgery treatment.

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Figures

Figure 1
Figure 1
Flow chart showing the document screening process and results.
Figure 2
Figure 2
The risk of bias of all the included studies the percentage of project judging.
Figure 3
Figure 3
Risk of bias: authors of all included studies each project risk of bias in judgment.
Figure 4
Figure 4
Comparison of overall survival rates between NACT group and RST group.
Figure 5
Figure 5
Comparison of the rate of lymph node metastasis between NACT group and RST Group.
Figure 6
Figure 6
Funnel plot for checking publication bias.
Figure 7
Figure 7
Comparison of operation time between NACT group and RST group.
Figure 8
Figure 8
Comparison of the estimated intraoperative blood loss between NACT group and RST group.
Figure 9
Figure 9
Comparison of the intraoperative and postoperative complication rates between NACT group and RST group.
Figure 10
Figure 10
Comparison of recurrence rate between NACT group and RST group.
See this image and copyright information in PMC

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