Xiao-Bin Huang1, Wen-Wen Zhang2, San-Gang Wu3, Jia-Yuan Sun2, Zhen-Yu He2, Juan Zhou4. 1. Gynecology Department, Foshan Maternal and Child Healthcare Hospital, Foshan, China. 2. Department of Radiation Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, China. 3. Department of Radiation Oncology, Xiamen Cancer Hospital, The First Affiliated Hospital of Xiamen University, Xiamen, China. 4. Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xiamen University, Xiamen, China.
Abstract
BACKGROUND AND OBJECTIVES: To determine the survival benefits of additional adjuvant hysterectomy in the International Federation of Gynecology and Obstetrics (FIGO) stage I-II cervical adenocarcinoma patients treated with radiochemotherapy. METHODS: Patients with FIGO stage I-II cervical adenocarcinoma were selected from the Surveillance, Epidemiology, and End Results 18 Regs research database. Propensity score matching (PSM) was used to balance patient baseline characteristics. Patient characteristics and outcomes were compared between the two groups. RESULTS: A total of 530 patients were included, 389 (73.4%) underwent definitive radiochemotherapy and 141 (26.6%) underwent an additional adjuvant hysterectomy. The multivariate Cox analysis surgery was shown to be an independent predictor of survival. Before PSM, the hazard ratios for cause-specific survival and overall survival in the surgery group were 0.632 (P = 0.036) and 0.674 (P = 0.041), respectively. After PSM, the respective hazard ratios were 0.392 (P < 0.001) and 0.465 (P = 0.001). The surgery group had significantly better 5-year cause-specific survival (80.5% vs 59.1%; P = 0.001) and overall survival than the nonsurgery group (76.3% vs 56.0%; P = 0.002). CONCLUSIONS: Additional adjuvant hysterectomy after radiochemotherapy may improve survival outcomes in patients with FIGO stage I-II cervical adenocarcinoma.
BACKGROUND AND OBJECTIVES: To determine the survival benefits of additional adjuvant hysterectomy in the International Federation of Gynecology and Obstetrics (FIGO) stage I-II cervical adenocarcinomapatients treated with radiochemotherapy. METHODS:Patients with FIGO stage I-II cervical adenocarcinoma were selected from the Surveillance, Epidemiology, and End Results 18 Regs research database. Propensity score matching (PSM) was used to balance patient baseline characteristics. Patient characteristics and outcomes were compared between the two groups. RESULTS: A total of 530 patients were included, 389 (73.4%) underwent definitive radiochemotherapy and 141 (26.6%) underwent an additional adjuvant hysterectomy. The multivariate Cox analysis surgery was shown to be an independent predictor of survival. Before PSM, the hazard ratios for cause-specific survival and overall survival in the surgery group were 0.632 (P = 0.036) and 0.674 (P = 0.041), respectively. After PSM, the respective hazard ratios were 0.392 (P < 0.001) and 0.465 (P = 0.001). The surgery group had significantly better 5-year cause-specific survival (80.5% vs 59.1%; P = 0.001) and overall survival than the nonsurgery group (76.3% vs 56.0%; P = 0.002). CONCLUSIONS: Additional adjuvant hysterectomy after radiochemotherapy may improve survival outcomes in patients with FIGO stage I-II cervical adenocarcinoma.