Papathemelis, Thomas and Knobloch, Stella and Gerken, Michael and Scharl, Anton and Anapolski, Michael and Ignatov, Atanas and Inwald, Elisabeth C. and Ortmann, Olaf and Scharl, Sophia and Klinkhammer-Schalke, Monika (2019) Impact of nodal status and treatment strategy on overall survival in advanced stage cervical cancer. JOURNAL OF CANCER RESEARCH AND CLINICAL ONCOLOGY, 145 (5). pp. 1369-1376. ISSN 0171-5216, 1432-1335
Full text not available from this repository. (Request a copy)Abstract
PurposeThe lack of prognostic data impedes implementation of optimal therapy for cervical cancer. For instance, recommended therapy for FIGO IIB cervical cancer is radical hysterectomy or radiochemotherapy. To enlighten different therapeutic approaches, we investigated the benefit of individual therapies or combination thereof in patients with or without infested lymph nodes.MethodsThe German Tumor Centre Regensburg registered 389 patients with FIGO IIB, IIIA, IIIB, and IVA cervical cancer between 2002 and 2015. We estimated hazard ratios (HR) for overall survival against different therapies using univariable and multivariable cox regression. After risk adjustment with respect to clinicopathological parameters, we performed model selection using conditional stepwise reverse selection.ResultsWe demonstrated the need for thorough assessment of the nodal status to obtain reliable data for treatment strategy. Our analysis showed significant differences for overall survival in FIGO IIB depending on therapy and nodal status. Outcome was inferior with radiochemotherapy without surgery for patients with N0 compared to surgery and radiochemotherapy combined (HR 3.012; 95% CI 1.075-8.441; p=0.036); however, for N1, radiochemotherapy without surgery resulted in comparable outcome (HR 0.808; 95% CI 0.189-3.403; p=0.765), whereas surgery alone yielded in poor outcome (HR 2.889; 95% CI 1.356-6.156; p=0.006). Regardless of the nodal status, chemotherapy was superior in advanced stage cervical cancer FIGO III to IVA.ConclusionsOur study suggests that in terms of oncological outcome FIGO IIB cervical cancer patients benefit from a combination of surgery and radiochemotherapy. However, in the presence of lymph node infestation, surgery does not add substantial benefit to the patient.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | ; Cervical cancer; Nodal status; Lymphadenectomy; Outcome; Overall survival; Therapy |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Frauenheilkunde und Geburtshilfe (Schwerpunkt Geburtshilfe) |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 09 Apr 2020 07:30 |
| Last Modified: | 09 Apr 2020 07:30 |
| URI: | https://pred.uni-regensburg.de/id/eprint/27104 |
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