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. 2022 Mar 4:12:823064.
doi: 10.3389/fonc.2022.823064. eCollection 2022.

Cervical Cancer Recurrence and Patient Survival After Radical Hysterectomy Followed by Either Adjuvant Chemotherapy or Adjuvant Radiotherapy With Optional Concurrent Chemotherapy: A Systematic Review and Meta-Analysis

Yu-Fei Zhang  1   2 , Yu Fan  1   2 , Peng Zhang  1   2 , Jia-Ying Ruan  1   2 , Yi Mu  2 , Jin-Ke Li  1
Affiliations

Cervical Cancer Recurrence and Patient Survival After Radical Hysterectomy Followed by Either Adjuvant Chemotherapy or Adjuvant Radiotherapy With Optional Concurrent Chemotherapy: A Systematic Review and Meta-Analysis

Yu-Fei Zhang et al. Front Oncol. .

Abstract

Objective: To compare cervical cancer recurrence and patient survival after radical hysterectomy followed by either adjuvant chemotherapy (AC) or adjuvant radiotherapy with or without concurrent chemotherapy (AR/CCRT).

Methods: We systematically searched PubMed, EMBASE, the Cochrane Library and clinicaltrials.gov to identify studies reporting recurrence or survival of cervical cancer patients who received AC or AR/CCRT after radical hysterectomy. Data were meta-analyzed using a random-effects model, and heterogeneity was evaluated using the I2 test. Subgroup and sensitivity analyses were performed to identify potential sources of heterogeneity.

Results: The meta-analysis included 14 non-randomized studies and two randomized controlled trials, altogether involving 5,052 cervical cancer patients. AC and AR/CCRT groups did not differ significantly in rates of total or local recurrence or mortality. Nevertheless, AC was associated with significantly lower risk of distant recurrence [odds ratio (OR) 0.67, 95% confidence interval (CI) 0.55-0.81] and higher rates of overall survival [hazard ratio (HR) 0.69, 95%CI 0.54-0.85] and disease-free survival rate (HR 0.77, 95%CI 0.62-0.92).

Conclusions: AC may be an effective alternative to AR/CCRT for cervical cancer patients after radical hysterectomy, especially younger women who wish to preserve their ovaries and protect them from radiation damage.

Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier PROSPERO (CRD42021252518).

Keywords: cervical cancer; chemoradiotherapy; meta-analysis; radical hysterectomy; radiotherapy.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow diagram of study selection.
Figure 2
Figure 2
Forest plot of the meta-analysis of (A) total recurrence rates, (B) local recurrence rates, (C) distant recurrence rates or (D) mortality rates in AC and AR/CCRT groups. AC, adjuvant chemotherapy; AR, adjuvant radiotherapy; CCRT, concurrent chemoradiotherapy; CI, confidence interval.
Figure 3
Figure 3
Forest plot of the meta-analysis of (A) overall survival rates or (B) disease-free survival rates in AC and AR/CCRT groups. AC, adjuvant chemotherapy; AR, adjuvant radiotherapy; CCRT, concurrent chemoradiotherapy; CI, confidence interval.
See this image and copyright information in PMC

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References

    1. World Health Organization . Human Papillomavirus (HPV) and Cervical Cancer (2021). Available at: http://www.who.int/mediacentre/factsheets/fs380/en/ (Accessed November 18, 2021).
    1. Global Cancer Observatory: Cancer Today (2021). International Agency for Research on Cancer. Available at: https://gco.iarc.fr/today (Accessed November 18, 2021).
    1. Li S, Hu T, Lv W, Zhou H, Li X, Yang R, et al. . Changes in Prevalence and Clinical Characteristics of Cervical Cancer in the People’s Republic of China:A Study of 10,012 Cases From a Nationwide Working Group. Oncologist (2013) 18(10):1101–7. doi: 10.1634/theoncologist.2013-0123 - DOI - PMC - PubMed
    1. Wipperman J, Neil T, Williams T. Cervical Cancer: Evaluation and Management. Am Fam Physician (2018) 97(7):449–54. - PubMed
    1. Koh WJ, Abu-Rustum NR, Bean S, Bradley K, Campos SM, Cho KR, et al. . Cervical Cancer, Version 3.2019, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw (2019) 17:64–84. doi: 10.6004/jnccn.2019.0001 - DOI - PubMed

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