Cargando…
Primary radical hysterectomy vs chemoradiation for IB2-IIA cervical cancer: A systematic review and meta-analysis
BACKGROUND: To compare the clinical outcomes of radical hysterectomy (RH) with chemoradiotherapy (CRT) in women with stage IB2-IIA cervical cancer. METHODS: Based on articles published up to December 2017, a literature search of PubMed, Embase, the Cochrane Central Register of Controlled Trials (CEN...
Autores principales: | , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health
2020
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7004581/ https://www.ncbi.nlm.nih.gov/pubmed/32000377 http://dx.doi.org/10.1097/MD.0000000000018738 |
_version_ | 1783494755106160640 |
---|---|
author | Yan, Ruo-nan Zeng, Zhen Liu, Fang Zeng, Yuan-yuan He, Tao Xiang, Zhong-zheng Zhang, Bai-lu Gong, Han-lin Liu, Lei |
author_facet | Yan, Ruo-nan Zeng, Zhen Liu, Fang Zeng, Yuan-yuan He, Tao Xiang, Zhong-zheng Zhang, Bai-lu Gong, Han-lin Liu, Lei |
author_sort | Yan, Ruo-nan |
collection | PubMed |
description | BACKGROUND: To compare the clinical outcomes of radical hysterectomy (RH) with chemoradiotherapy (CRT) in women with stage IB2-IIA cervical cancer. METHODS: Based on articles published up to December 2017, a literature search of PubMed, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), and Chinese National Knowledge Infrastructure (CNKI) databases was conducted to identify eligible studies. Overall survival (OS), progression-free survival (PFS) with hazard ratios (HRs), and toxicities with odds ratios (ORs) were analyzed. RESULTS: In total, 7 studies comprising 687 patients were identified for this meta-analysis. RH showed a significant trend toward improved survival outcomes compared with those of CRT, regardless of OS (HR = 0.49, 95% confidence interval [CI] 0.36–0.67, P < .001); or PFS (1.61, 95% CI 1.15–2.26, P = .005) for IB2-IIA cervical cancer. Subgroup analysis revealed that stage IB2 cervical cancer patients obtained better OS (HR = 0.36, 95% CI 0.23–0.56, P < .001; heterogeneity: P = .32, I(2) = 13%). However, a higher incidence of grade 3/4 genitourinary abnormalities was evident with RH (OR = 2.3, 95% CI 1.42–3.87, P = .021). CONCLUSION: Our study suggested that RH had distinct advantages over CRT for carcinoma of the uterine cervix with FIGO stage IB2-IIA, especially for IB2 cervical cancer. |
format | Online Article Text |
id | pubmed-7004581 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
spelling | pubmed-70045812020-02-18 Primary radical hysterectomy vs chemoradiation for IB2-IIA cervical cancer: A systematic review and meta-analysis Yan, Ruo-nan Zeng, Zhen Liu, Fang Zeng, Yuan-yuan He, Tao Xiang, Zhong-zheng Zhang, Bai-lu Gong, Han-lin Liu, Lei Medicine (Baltimore) 5700 BACKGROUND: To compare the clinical outcomes of radical hysterectomy (RH) with chemoradiotherapy (CRT) in women with stage IB2-IIA cervical cancer. METHODS: Based on articles published up to December 2017, a literature search of PubMed, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), and Chinese National Knowledge Infrastructure (CNKI) databases was conducted to identify eligible studies. Overall survival (OS), progression-free survival (PFS) with hazard ratios (HRs), and toxicities with odds ratios (ORs) were analyzed. RESULTS: In total, 7 studies comprising 687 patients were identified for this meta-analysis. RH showed a significant trend toward improved survival outcomes compared with those of CRT, regardless of OS (HR = 0.49, 95% confidence interval [CI] 0.36–0.67, P < .001); or PFS (1.61, 95% CI 1.15–2.26, P = .005) for IB2-IIA cervical cancer. Subgroup analysis revealed that stage IB2 cervical cancer patients obtained better OS (HR = 0.36, 95% CI 0.23–0.56, P < .001; heterogeneity: P = .32, I(2) = 13%). However, a higher incidence of grade 3/4 genitourinary abnormalities was evident with RH (OR = 2.3, 95% CI 1.42–3.87, P = .021). CONCLUSION: Our study suggested that RH had distinct advantages over CRT for carcinoma of the uterine cervix with FIGO stage IB2-IIA, especially for IB2 cervical cancer. Wolters Kluwer Health 2020-01-31 /pmc/articles/PMC7004581/ /pubmed/32000377 http://dx.doi.org/10.1097/MD.0000000000018738 Text en Copyright © 2020 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc-nd/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0 |
spellingShingle | 5700 Yan, Ruo-nan Zeng, Zhen Liu, Fang Zeng, Yuan-yuan He, Tao Xiang, Zhong-zheng Zhang, Bai-lu Gong, Han-lin Liu, Lei Primary radical hysterectomy vs chemoradiation for IB2-IIA cervical cancer: A systematic review and meta-analysis |
title | Primary radical hysterectomy vs chemoradiation for IB2-IIA cervical cancer: A systematic review and meta-analysis |
title_full | Primary radical hysterectomy vs chemoradiation for IB2-IIA cervical cancer: A systematic review and meta-analysis |
title_fullStr | Primary radical hysterectomy vs chemoradiation for IB2-IIA cervical cancer: A systematic review and meta-analysis |
title_full_unstemmed | Primary radical hysterectomy vs chemoradiation for IB2-IIA cervical cancer: A systematic review and meta-analysis |
title_short | Primary radical hysterectomy vs chemoradiation for IB2-IIA cervical cancer: A systematic review and meta-analysis |
title_sort | primary radical hysterectomy vs chemoradiation for ib2-iia cervical cancer: a systematic review and meta-analysis |
topic | 5700 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7004581/ https://www.ncbi.nlm.nih.gov/pubmed/32000377 http://dx.doi.org/10.1097/MD.0000000000018738 |
work_keys_str_mv | AT yanruonan primaryradicalhysterectomyvschemoradiationforib2iiacervicalcancerasystematicreviewandmetaanalysis AT zengzhen primaryradicalhysterectomyvschemoradiationforib2iiacervicalcancerasystematicreviewandmetaanalysis AT liufang primaryradicalhysterectomyvschemoradiationforib2iiacervicalcancerasystematicreviewandmetaanalysis AT zengyuanyuan primaryradicalhysterectomyvschemoradiationforib2iiacervicalcancerasystematicreviewandmetaanalysis AT hetao primaryradicalhysterectomyvschemoradiationforib2iiacervicalcancerasystematicreviewandmetaanalysis AT xiangzhongzheng primaryradicalhysterectomyvschemoradiationforib2iiacervicalcancerasystematicreviewandmetaanalysis AT zhangbailu primaryradicalhysterectomyvschemoradiationforib2iiacervicalcancerasystematicreviewandmetaanalysis AT gonghanlin primaryradicalhysterectomyvschemoradiationforib2iiacervicalcancerasystematicreviewandmetaanalysis AT liulei primaryradicalhysterectomyvschemoradiationforib2iiacervicalcancerasystematicreviewandmetaanalysis |