Impact of neoadjuvant chemotherapy on the postoperative pathology of locally advanced cervical squamous cell carcinomas: 1:1 propensity score matching analysis. Issue 5 (May 2021)

• Record Type: Journal Article
• Authors: Li, Pengfei; Fang, Ziyu; Li, Weili; Hao, Min; Wang, Wuliang; Kang, Shan; Guo, Jianxin; Yang, Ying; Ni, Yan; Zhao, Weidong; Lu, Anwei; Ling, Bin; Li, Donglin; Lang, Jinghe; Chen, Chunlin; Liu, Ping
• Is Part Of: European journal of surgical oncology. Volume 47:Issue 5(2021)
• Page Start: 1069
• Page End: 1074
• Publication Date: 2021-05
• Subjects: Neoadjuvant chemotherapy -- Locally advanced -- Cervical squamous cell carcinomas -- Postoperative pathology; Oncology -- Periodicals; Cancer -- Surgery -- Periodicals; Medical Oncology -- Periodicals; Neoplasms -- surgery -- Periodicals; Cancer -- Chirurgie -- Périodiques; Cancérologie -- Périodiques; Oncologie; Chirurgie (geneeskunde); Electronic journals; Electronic journals -- Sciences; Electronic journals -- Medicine; Electronic journals; 616.994059005
• DOI: 10.1016/j.ejso.2020.09.013
• Languages: English
• ISSNs: 0748-7983

Abstract

Abstract: Objective: To assess the impact of neoadjuvant chemotherapy on postoperative pathology for stage IB2 and IIA2 cervical squamous cell carcinoma. Methods: Postoperative pathology was compared between patients who received neoadjuvant chemotherapy followed by radical hysterectomy (NACT group) and patients who received upfront radical hysterectomy (URH group). Then, patients in the NACT group were divided into a chemotherapy-sensitive group and a chemotherapy-insensitive group according to their response to chemotherapy. Results: After 1:1 propensity score matching (PSM), the positive rates of lymphovascular space invasion (LVSI) (7.9% vs 17.7%, P = 0.001) and cervical deep stromal invasion (60.4% vs 76.2%, P < 0.001) in the NACT group were significantly lower than those in the URH group, while the positive rates of parametrial invasion, lymph node metastasis, and vaginal margin invasion were not significantly different between the two groups. The rate of positive lymph node metastasis in the chemotherapy-sensitive group was significantly lower than that in the URH group (18.1% vs 26.5%, P = 0.037). Conclusion: Among patients with stage IB2 and IIA2 cervical squamous cell carcinomas, NACT can reduce the positive rate of intermediate-risk factors, such as deep cervical stromal invasion and LVSI, but cannot reduce the positive rate of high-risk factors. For patients who are chemotherapy sensitive, NACT can reduce the positive rate of lymph node metastasis. Highlights: 1. NACT can reduce positive intermediate-risk factors. 2. NACT cannot reduce positive high-risk factors. 3. NACT can reduce positive lymph node metastasis for chemotherapy-sensitive patients.