The association between short-term response and long-term survival for cervical cancer patients undergoing neoadjuvant chemotherapy: a system review and meta-analysis

Controversy exists regarding whether a short-term response has an impact on the long-term survival of cervical cancer patients undergoing neoadjuvant chemotherapy (NACT). This study was designed to identify the predictive role of an early response by pooling the results of previous studies. The PubMed and Embase databases were searched through July 2016, and the associations between an early response and disease-free survival (DFS) were pooled by hazard ratio (HR) using random effects models. Six studies involving 490 cervical cancer patients, with 336 responders and 154 non-responders, were finally included in the meta-analysis. The HR for 1-year DFS between early responders and non-responders was 0.25 (95% CI 0.10–0.58, P = 0.001). The HRs for 2-, 3-, 4-, and 5-year DFS were 0.28 (95% CI 0.15–0.56), 0.27 (95% CI 0.16–0.45), 0.29 (95% CI 0.17–0.50) and 0.33 (95% CI 0.20–0.54), respectively. No obvious heterogeneity was found among the studies, with I(2) = 0, and a sensitivity analysis showed that all pooled results were robust with logHR confidence limits < 0. An early response was associated with DFS, and responders achieved a significantly higher survival rate than non-responders. This finding should be validated in future prospective studies.