Survival outcomes and risk factors of patients with stage ⅡB cervical cancer undergoing neoadjuvant chemotherapy followed by radical hysterectomy

Abstract

Objective To investigate the survival outcomes and risk factors of patients with stage ⅡB cervical cancer undergoing neoadjuvant chemotherapy (NACT) followed by laparoscopic radical hysterectomy (LRH). Methods A retrospective cohort study was conducted on 178 patients with stage ⅡB cervical cancer who underwent NACT followed by LRH in our department from 2015 to 2018. COX regression analysis was used to analyze the surgical pathological characteristics, and stratified analysis was performed according to the results. Kaplan-Meier survival curve analysis and log-Rank test were employed to analyze the survival outcomes of different subgroups. Results For the 178 subjected patients, their median follow-up period was 51 months, and the rates of 3-year disease-free survival (DFS) and overall survival (OS) were 75.4% and 82.6%, respectively. COX regression analysis showed that lymph node metastasis (LNM) (HR: 2.04, 95%CI: 1.16~3.60) and deep stromal invasion (DSI) (HR: 4.72, 95%CI: 2.11~10.60) were independent risk factors for DFS. LNM (HR: 2.77, 95%CI: 1.48~5.22), DSI (HR: 4.24, 95%CI: 1.64~10.98) and tumor diameter ≥4 cm after NACT (HR: 2.12, 95%CI: 1.14~3.94) were independent risk factors for OS. The rates of 3-year DFS of patients with and without LNM was 55.3% and 81.0% (P 50% after NACT were significantly better than those ≤50% (the 3-year DFS rate: 92.9% vs 71.0%, P 50% after NACT have better survival outcomes. LNM, DSI and tumor diameter ≥4 cm after NACT are independent risk factors for the prognosis of stage ⅡB cervical cancer.

Keywords

• cervical cancer
• laparoscopy
• radical hysterectomy
• neoadjuvant chemotherapy
• recurrence and metastasis
• survival outcome