Treatment of FIGO 2018 stage IIIC cervical cancer with different local tumor factors

Yanna Ye; Zhiqiang Li; Shan Kang; Yongxiu Yang; Bin Ling; Li Wang; Jilong Yao; Pengfei Li; Xueqin Wang; Shipeng Gong; Huijian Fan; Yanxiang Kong; Yuye Cao; Jinghe Lang; Ping Liu; Chunlin Chen

doi:10.1186/s12885-023-10801-w

Treatment of FIGO 2018 stage IIIC cervical cancer with different local tumor factors

BMC Cancer. 2023 May 9;23(1):421. doi: 10.1186/s12885-023-10801-w.

Authors

Yanna Ye^#^{1

2}, Zhiqiang Li^#¹, Shan Kang^#³, Yongxiu Yang^#⁴, Bin Ling⁵, Li Wang⁶, Jilong Yao⁷, Pengfei Li¹, Xueqin Wang⁸, Shipeng Gong¹, Huijian Fan⁹, Yanxiang Kong¹⁰, Yuye Cao¹, Jinghe Lang^{1

11}, Ping Liu¹², Chunlin Chen¹³

Affiliations

¹ Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, No. 1838, Guangzhou Avenue, Guangzhou, 510515, China.
² Department of Midwifery, Faculty of Health, Dongguan Polytechnic, Dongguan, 523000, China.
³ Department of Gynecology, Fourth HospitalHebei Medical University, Shijiazhuang, 050019, China.
⁴ Department of Obstetrics and Gynecology, First Hospital, Lanzhou University, Lanzhou, 730000, China.
⁵ Department of Obstetrics and Gynecology, China-Japan Friendship Hospital, Beijing, 100029, China.
⁶ Department of Gynecologic Oncology, Affiliated Cancer Hospital, Zhengzhou University, Zhengzhou, 450008, China.
⁷ Shenzhen Maternal and Child Health Hospital, Shenzhen, 518028, China.
⁸ Department of Obstetrics and Gynecology, The Fifth Affiliated Hospital, Southern Medical University, Guangzhou, 510920, China.
⁹ The Third Affiliated Hospital, Guangzhou Medical University, Guangzhou, 510150, China.
¹⁰ Reproductive Medicine Center, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, 518107, China.
¹¹ Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Beijing, 100193, China.
¹² Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, No. 1838, Guangzhou Avenue, Guangzhou, 510515, China. lp2@smu.edu.cn.
¹³ Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, No. 1838, Guangzhou Avenue, Guangzhou, 510515, China. ccl1@smu.edu.cn.

^# Contributed equally.

Abstract

Background: To compare the oncological outcomes of patients with FIGO 2018 stage IIIC cervical cancer (CC) involving different local tumor factors who underwent abdominal radical hysterectomy (ARH), neoadjuvant chemotherapy and radical surgery (NACT), or radical chemoradiotherapy (R-CT).

Methods: Based on tumor staging, patients with stage IIIC were divided into T1, T2a, T2b, and T3 groups. Kaplan-Meier and Cox proportional hazards regression analysis were used to compare their overall survival (OS) and disease-free survival (DFS) of 5 years.

Results: We included 4,086 patients (1,117, 1,019, 869, and 1,081 in the T1, T2a, T2b, and T3 groups, respectively). In the T1 group, NACT was correlated with a decrease in OS (hazard ratio [HR] = 1.631, 95% confidence interval [CI]: 1.150-2.315, P = 0.006) and DFS (HR = 1.665, 95% CI: 1.255-2.182, P < 0.001) than ARH. ARH and NACT were not correlated with OS (P = 0.226 and P = 0.921) or DFS (P = 0.343 and P = 0.535) than R-CT. In the T2a group, NACT was correlated with a decrease in OS (HR = 1.454, 95% CI: 1.057-2.000, P = 0.021) and DFS (HR = 1.529, 95% CI: 1.185-1.974, P = 0.001) than ARH. ARH and NACT were not correlated with OS (P = 0.736 and P = 0.267) or DFS (P = 0.714 and P = 0.087) than R-CT. In the T2b group, NACT was correlated with a decrease in DFS (HR = 1.847, 95% CI: 1.347-2.532, P < 0.001) than R-CT nevertheless was not correlated with OS (P = 0.146); ARH was not correlated with OS (P = 0.056) and DFS (P = 0.676). In the T3 group, the OS rates of ARH (n = 10), NACT (n = 18), and R-CT (n = 1053) were 67.5%, 53.1%, and 64.7% (P = 0.941), and the DFS rates were 68.6%, 45.5%, and 61.1%, respectively (P = 0.761).

Conclusion: R-CT oncological outcomes were not entirely superior to those of NACT or ARH under different local tumor factors with stage IIIC. NACT is not suitable for stage T1, T2a, and T2b. Nevertheless ARH is potentially applicable to stage T1, T2a, T2b and T3. The results of stage T3 require confirmation through further research due to disparity in case numbers in each subgroup.

Keywords: Cervical cancer; FIGO 2018 stage IIIC; Local tumor factors; Treatment.

MeSH terms

Disease-Free Survival
Female
Humans
Medical Oncology
Neoadjuvant Therapy
Progression-Free Survival
Uterine Cervical Neoplasms* / therapy

Abstract

MeSH terms

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