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. 2022 Jul 6:12:933755.
doi: 10.3389/fonc.2022.933755. eCollection 2022.

Survival Outcomes of Patients With Stage IB3 Cervical Cancer Who Undergo Abdominal Radical Hysterectomy Versus Radiochemotherapy

Zhiqiang Li  1 , Qing Yang  2 , Jianxin Guo  3 , Guoqiang Liang  1 , Hui Duan  1 , Shaoguang Wang  4 , Min Hao  5 , Wentong Liang  6 , Donglin Li  6 , Xuemei Zhan  7 , Qinghuang Xie  8 , Jinghe Lang  1   9 , Ping Liu  1 , Chunlin Chen  1
Affiliations

Survival Outcomes of Patients With Stage IB3 Cervical Cancer Who Undergo Abdominal Radical Hysterectomy Versus Radiochemotherapy

Zhiqiang Li et al. Front Oncol. .

Abstract

Objective: This study aimed to compare the survival outcomes among stage IB3 cervical cancer patients who undergo abdominal radical hysterectomy (ARH)+pelvic lymphadenectomy ± para-aortic lymph node dissection versus radiochemotherapy (R-CT).

Methods: Based on the large number of diagnoses and treatments for cervical cancer in the Chinese database, propensity score matching (PSM) was used to compare the 5-year overall survival (OS) and disease-free survival (DFS) rates of the ARH group and R-CT group.

Results: There were 590 patients with stage IB3 cervical cancer according to the FIGO 2018 staging system, with 470 patients in the ARH group and 120 patients in the R-CT group. The ARH and R-CT groups showed different 5-year OS and DFS rates in the total study population, and the 5-year OS and DFS rates in the R-CT group (n = 120) were lower than those in the ARH group (n = 470) (OS: 78.1% vs. 92.1%, p < 0.001; DFS: 71.6% vs. 90.3%, p < 0.001). R-CT was associated with a worse 5-year OS rate (hazard ratio [HR] = 3.401; 95% confidence interval [CI] = 1.875-6.167; p < 0.001) and DFS rate (HR = 3.440; 95% CI = 2.075-5.703; p < 0.001) by Cox multivariate analysis. After 1:3 PSM, the 5-year OS and DFS rates in the R-CT group (n = 108) were lower than those in the RH group (n = 280) (OS: 76.4% vs. 94.0%, p < 0.001; DFS: 69.3% vs. 92.6%, p < 0.001, respectively). R-CT was associated with a worse 5-year OS rate (HR = 4.071; 95% CI = 2.042-8.117; p < 0.001) and DFS rate (HR = 4.450; 95% CI = 2.441-8.113; p < 0.001) by Cox multivariate analysis.

Conclusion: Our study found that for FIGO 2018 stage IB3 cervical cancer patients, ARH resulted in better OS and DFS than R-CT.

Keywords: abdominal radical hysterectomy; cervical cancer; disease-free survival; overall survival; radiochemotherapy; stage IB3 cervical cancer.

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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 recruitment and exclusions. ARH, abdominal radical hysterectomy; R-CT, radio-chemotherapy.
Figure 2
Figure 2
The 5-year OS and DFS in ARH group and R-CT group before PSM.
Figure 3
Figure 3
The 5-year OS and DFS in ARH group and R-CT group after PSM.
See this image and copyright information in PMC

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