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. 2022 Apr 14:12:800049.
doi: 10.3389/fonc.2022.800049. eCollection 2022.

Discussion on the Treatment Strategy for Stage ⅡA1 Cervical Cancer (FIGO 2018)

Xiaolin Chen  1 , Wentong Liang  2 , Hui Duan  1 , Minling Wu  1 , Xuemei Zhan  3 , Encheng Dai  4 , Qiubo Lv  5 , Qinghuang Xie  6 , Ruilei Liu  4 , Yan Xu  7 , Xiaonong Bin  8 , Jinghe Lang  9 , Ping Liu  1 , Chunlin Chen  1
Affiliations

Discussion on the Treatment Strategy for Stage ⅡA1 Cervical Cancer (FIGO 2018)

Xiaolin Chen et al. Front Oncol. .

Abstract

Objective: This study aimed to explore the best treatment strategy for International Federation of Gynecology and Obstetrics (FIGO) 2018 stage IIA1 cervical cancer patients by comparing the survival outcomes of two treatment methods: abdominal radical hysterectomy (ARH) with standard postoperative therapy and radio-chemotherapy (R-CT).

Methods: Patients with FIGO2018 stage IIA1 cervical cancer who underwent ARH or received R-CT were screened from the clinical diagnosis and treatment for cervical cancer in China (Four C) database. The recurrence cases between the two groups were analyzed. The 5-year overall survival (OS) and disease-free survival (DFS) of patients diagnosed with stage IIA1 cervical cancer in 47 hospitals in mainland China between 2004 and 2018 were compared by using propensity score matching (PSM).

Results: A total of 724 patients met the inclusion criteria. In the total study population, The R-CT group had higher recurrence (22.8% for the R-CT group and 11.2% for the ARH group, P<0.001) rates compared to the ARH group.The 5-year OS and DFS of the ARH group (n=658) were significantly higher than those of the R-CT group (n=66) (OS: 85.9% vs. 71.2%, P=0.009; DFS: 79.2%vs. 70.5%, P=0.027). R-CT was associated with worse 5-year OS (HR=3.19, 95% CI: 1.592-6.956, P=0.001) and DFS (HR=2.089, 95% CI: 1.194-3.656, P=0.01). After 1:2 PSM, the 5-year OS and DFS of the ARH group (n=126) were significantly higher than those of the R-CT group (n=64) (OS:88.9% vs. 70.1%, P=0.04; DFS:82.8% vs. 69.8%, P=0.019). R-CT was still associated with worse 5-year OS (HR=2.391, 95% CI: 1.051-5.633, P=0.046) and DFS (HR=2.6, 95% CI: 1.25-5.409, P=0.011).

Conclusion: Our study demonstrated that for stage FIGO2018 stage IIA1 cervical cancer patients, ARH offers better oncological outcomes than R-CT.

Keywords: cervical cancer; disease-free survival; overall survival; stage ⅡA1; treatment strategies.

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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 patient recruitment and exclusions.
Figure 2
Figure 2
The 5-year OS and DFS rates of the ARH group and R-CT groups before and after 1:2 matching. Before matching, panels A and B; after matching, panels C and D.
See this image and copyright information in PMC

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