Effect of pre-operative radiotherapy on long-term outcomes among women with Stage IB1 to IIB cervical squamous cell carcinoma

作者：Liu, Ping; Dai, Encheng; Li, Weili; He, Fangjie; Yang, Rui; Bin, Xiaonong; Lang, Jinghe; Chen, Chunlin^*

来源：INTERNATIONAL JOURNAL OF GYNECOLOGY & OBSTETRICS, 2021, 152(1): 125-132.

DOI：10.1002/ijgo.13463

• Cervical cancer
• Disease&#8208
• free survival
• Matching
• Overall survival
• Preoperative radiotherapy

Objective To compare long-term outcomes between pre-operative radiotherapy followed by open surgery and direct open surgery among women with Stage IB1-IIB cervical squamous cell carcinoma. @@@ Methods A multicenter retrospective cohort study among women with Stage IB1-IIB cervical squamous cell carcinoma who underwent open surgery either directly (SD group) or with pre-operative radiotherapy (PR group) in China 2004-2016. Five-year overall survival (OS) and disease-free survival (DFS) between the two groups were compared by Kaplan-Meier methods and multivariate Cox regression. @@@ Results Overall, 8385 women with Stage IB1-IIB were included (PR group, n = 447; SD group, n = 7938). Five-year OS and DFS was significantly lower in the PR than in the SD group (OS: 81.7% vs 91.6%, P < 0.001; DFS: 76.3% vs 86.7%, P < 0.001). As compared with direct surgery, pre-operative radiotherapy was an independent risk factor for 5-year OS (adjusted hazard raio [aHR], 1.75; 95% confidence interval [CI], 1.34-2.30) and DFS (aHR, 1.37; 95% CI, 1.09-1.73) by multivariate Cox regression. Sensitivity analyses confirmed the findings. @@@ Conclusion Among women with Stage IB1-IIB cervical squamous cell carcinoma, outcomes were found to be worse for those undergoing pre-operative radiotherapy followed by open surgery than for those undergoing direct open surgery.

• 单位
  中国医学科学院北京协和医院; 广州医学院; 北京大学; 南方医科大学