Abstract 866P
Background
The optimal therapy strategy for locally advanced cervical cancer is uncertain, and whether neoadjuvant chemotherapy followed by radical surgery (NACT+RS) could replace the standard concurrent chemoradiation (CCRT) is controversial. We retrospectively evaluated clinical outcomes and adverse effects of patients treated in two different ways and tried to figure out this question.
Methods
Patients diagnosed as stage IIA-IIIA cervical carcinoma according to International Federation of Gynecology and Obstetrics criteria (FIGO) in our institution from January 2013 to June 2018 were enrolled in this study. Patients were treated neoadjuvant chemotherapy followed by radical surgery or concurrent chemoradiation. The primary end points were overall survival (OS) and disease-free survival (DFS). The secondary end points were short-term and long-term adverse effects. The KaplanMeier method and log-rank test were used for statistical analysis.
Results
In total, 277 patients who underwent NACT+RS and 272 patients who received CCRT were enrolled. In the NACT+RS group, the 5-year OS rate was 87.9%, while the CCRT group was 79.6% with unadjusted hazard ratio (HR) as1.814 (95% CI, 0.569 to 5.788; P = 0.307). There showed no difference between two groups. The similar results could be found in 5-year DFS rates as 80% and 74% in NACT+RS group and CCRT group, respectively (HR, 1.344; 95% CI, 0.536 to 3.368; P=0.525). OS rates of 1 year were 99.1% vs. 97.5% (P=0.208) in NACT+RS group and CCRT group, and 3 years were 93.3% vs. 86.1% (P=0.057). Meanwhile, DFS rates of 1 year were 95.6% vs. 92.5% (P=0.161), and 3-years were 84.7% vs.80.1% (P=0.322) for two groups separately. Referring to short-term adverse effects, NACT+RS Group had a lower rate of rectal (P <0.05) toxicity. In terms of long-term adverse effects, there was no statistical significant difference between two groups no matter for bladder or vaginal complications.
Conclusions
For patients with stage IIA-IIIA cervical cancer, NACT+ RS did not show an improvement on survival outcomes or long-term adverse effects compared with CCRT. It needs more randomized trials to investigate its role in locally advanced cervical cancer.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The First Affiliated Hospital of Chongqing Medical University.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.