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Neoadjuvant chemotherapy for patients with international federation of gynecology and obstetrics stages IB3 and IIA2 cervical cancer: a multicenter prospective trial

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作者：
Hu Yingjie[1] * ; Han Yingyan[1] * ; Shen Yuanming[2] * ; Chen Jing[1] ; Chen Yaheng[1] ; Chen Yile[3] ; Tang Junying[4] ; Xue Min[5] ; Hong Li[6] ; Cheng Wenjun[7] ; Wang Danbo[8] ; Liang Zhiqing[9] ; Wang Yifeng[10] ; Zhang Qinghua[11] ; Xing Hui[12] ; Zhang Yu[13] ; Yi Cunjian[14] ; Yu Zhiying[15,16] ; Chen Youguo[17] ; Cui Manhua[18] ; Ma Cailing[19] ; Yang Hongying[20] ; Li Ruizhen[21] ; Long Ping[22] ; Zhao Yu[23] ; Qu Pengpeng[24] ; Tao Guangshi[25] ; Yang Lihua[26] ; Wu Sufang[27] ; Liu Zhihua[28] ; Yang Ping[29] ; Lv Weiguo[2] ; Xie Xing[2] ; Ma Ding[1] ; Wang Hui[2] ; Li Kezhen[1] ;
机构： [1]Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China. [2]Department of Gynecologic Oncology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China. [3]Department of Gynecologic Oncology, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China. [4]Department of Gynecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China. [5]Department of Gynecology and Obstetrics, The Third Xiangya Hospital of Central South University, Changsha, Hunan, China. [6]Department of Obstetrics and Gynaecology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China. [7]Department of Gynecology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China. [8]Department of Gynecology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang, Liaoning, China. [9]Department of Obstetrics and Gynecology, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China. [10]Department of Gynecology, Obstetrics and Gynecology Center, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China. [11]Department of Obstetrics and Gynecology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China. [12]Department of Obstetrics and Gynaecology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, China. [13]Department of Gynecology, Xiangya Hospital, Central South University, Changsha, Hunan, China. [14]Department of Obstetrics and Gynecology, The First Affiliated Hospital of Yangtze University, Jingzhou, Hubei, China. [15]Department of Gynecology, The First Affiliated Hospital of Shenzhen University, Health Science Center [16]Shenzhen Second People’s Hospital, Shenzhen, Guangdong, China. [17]Department of Obstetrics and Gynecology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China. [18]Department of Gynecology and Obstetrics, The Second Hospital of Jilin University, Changchun, Jilin, China. [19]Department of Gynecology, the First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China. [20]Department of Gynecology, Yunnan Tumor Hospital and The Third Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China. [21]Department of Gynecology and Obstetrics, Shenzhen Hospital of Beijing University, Shenzhen, Guangdong, China. [22]The Second People’s Hospital of Jingmen, Hubei, Jingmen, China. [23]Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China. [24]Department of Gynecology Oncology, Tianjin Central Hospital of Gynecology and Obstetrics, Tianjin, China. [25]Department of Obstetrics and Gynecology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China. [26]Department of Obstetrics and Gynecology, The Second Affiliated Hospital, Kunming Medical University, Kunming,Yunnan, China. [27]Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. [28]Department of Gynecology, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, Guangdong, China. [29]Department of Obstetrics and Gynecology, First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi, Xinjiang, China.
出处：
DOI： 10.1186/s12885-022-10355-3
ISSN：

摘要：
Preoperative neoadjuvant chemotherapy (NACT) has been widely used in developing countries for the treatment of patients with International Federation of Gynecology and Obstetrics (FIGO) stages IB3 and IIA2 cervical cancer. However, the effectiveness of NACT and treatment options for NACT-insensitive patients have been concerning. This study will assess prognostic differences between NACT and primary surgery treatment (PST), determine factors associated with prognosis, and explore better adjuvant treatment modalities for NACT-insensitive patients.This study analyzed clinical characteristics, pathological characteristics, treatment options, and follow-up information of 774 patients with FIGO stages IB3 and IIA2 cervical cancer from 28 centers from January 2016 to October 2019 who participated in a multicenter, prospective, randomized controlled trial.For patients undergoing NACT, the 5-year OS and PFS rate was 85.8 and 80.5% respectively. They were similar in the PST group. There was no significant difference in OS and PFS between clinical response (CR)/partial response (PR) groups and stable disease (SD)/progressive disease (PD) groups. Apart from deep cervical invasion (p = 0.046) affecting OS for patients undergoing NACT, no other clinical and pathological factors were associated with OS. 97.8% of NACT-insensitive patients opted for surgery. If these patients did not have intermediate- or high-risk factors, whether they had undergone postoperative adjuvant therapy was irrelevant to their prognosis, whereas for patients with intermediate- or high-risk factors, adjuvant chemotherapy resulted in better PFS (chemotherapy vs. no therapy, p < 0.001; chemotherapy vs. radiotherapy, p = 0.019) and OS (chemotherapy vs. no therapy, p < 0.001; chemotherapy vs. radiotherapy, p = 0.002).NACT could be a choice for patients with FIGO stages IB3 and IIA2 cervical cancer. The main risk factor influencing prognosis in the NACT group is deep cervical invasion. After systematic treatment, insensitivity to NACT does not indicate a poorer prognosis. For NACT-insensitive patients, Chinese prefer surgery. Postoperative adjuvant therapy in patients with no intermediate- or high-risk factors does not improve prognosis, and chemotherapy in patients with intermediate- and high-risk factors is more effective than radiation therapy and other treatments.The study was prospectively registered on ClinicalTrials.gov (NCT03308591); date of registration: 12/10/2017.© 2022. The Author(s).

基金：
This work was supported by the National Key Technology Research and Developmental Program of China (2022YFC2704400; 2022YFC2704403), Clinical Medical Research Center for Obstetrical and Gynecological Diseases (2015BAI13B05), the National Key Technology R&D Program of China(2019YFC1005200, 2019YFC1005202), Health and Family Planning Commission of Hubei Province (WJ2019M127), and Research Projects of Tongji Hospital (2022B02).
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外文
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出版当年[2022]版：
大类 | 2 区 医学
小类 | 3 区 肿瘤学
最新[2023]版：
大类 | 2 区 医学
小类 | 3 区 肿瘤学
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出版当年[2021]版：
Q2 ONCOLOGY
最新[2023]版：
Q2 ONCOLOGY

影响因子： 最新[2023版] 最新五年平均 出版当年[2021版] 出版当年五年平均 出版前一年[2020版] 出版后一年[2022版]

第一作者：
第一作者机构： [1]Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
共同第一作者：
通讯作者：
推荐引用方式(GB/T 7714)：
Hu Yingjie,Han Yingyan,Shen Yuanming,et al.Neoadjuvant chemotherapy for patients with international federation of gynecology and obstetrics stages IB3 and IIA2 cervical cancer: a multicenter prospective trial[J].BMC CANCER.2022,22(1):doi:10.1186/s12885-022-10355-3.
APA：
Hu Yingjie,Han Yingyan,Shen Yuanming,Chen Jing,Chen Yaheng...&Li Kezhen.(2022).Neoadjuvant chemotherapy for patients with international federation of gynecology and obstetrics stages IB3 and IIA2 cervical cancer: a multicenter prospective trial.BMC CANCER,22,(1)
MLA：
Hu Yingjie,et al."Neoadjuvant chemotherapy for patients with international federation of gynecology and obstetrics stages IB3 and IIA2 cervical cancer: a multicenter prospective trial".BMC CANCER 22..1(2022)

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