Weili Li1, Ping Liu1, Weidong Zhao2, Zhaohong Yin1, Zhong Lin3, Xiaonong Bin4, Jinghe Lang5, Chunlin Chen6. 1. Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, No.1838, North Guanghzou Avenue, Guangzhou, 510515, China. 2. Department of Gynecology and Oncology, The First Affiliated Hospital of University of Science and Technology of China, Hefei, Anhui, 230009, China. 3. Department of Medicine Maternal and Child Health Care Hospital of Liuzhou No.50 Yingshan Street, Liuzhou, Guangxi, 545001, China. 4. Department of Epidemiology, College of Public Health, Guangzhou Medical University, Guangzhou, 511436, China. 5. Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, No.1838, North Guanghzou Avenue, Guangzhou, 510515, China; Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Beijing, 100730, China. 6. Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, No.1838, North Guanghzou Avenue, Guangzhou, 510515, China. Electronic address: ccl1@smu.edu.cn.
Abstract
OBJECTIVE: To investigate the effect of preoperative radiotherapy or chemoradiotherapy combined with radical surgery on pathological outcomes in cervical cancer patients. METHODS: Based on a large Chinese cervical cancer database of clinical diagnosis and treatment (C4 Project), the postoperative pathological outcomes of patients who received preoperative radiotherapy or chemoradiotherapy followed by open surgery (PR group) or surgery alone (SD group) were compared. RESULTS: Among the strictly selected patients, the incidence of lymph node metastasis in the PR group (n = 574) was higher than that in the SD group (231 VS 9; P < 0.001), while the incidence of vascular space invasion was lower than that in the SD group (72 VS 2041; P < 0.001). The logistic regression analysis showed that preoperative radiotherapy was a protective factor for parametrial involvement, positive surgical margins, deep cervical stromal invasion, and vascular space invasion (P < 0.05). The median number of resected lymph nodes in both groups was 18. After 1:1 case matching, the incidence of deep cervical stromal invasion and vascular space invasion was reduced by preoperative radiotherapy (292 vs 376, P < 0.001; 60 vs 106, P < 0.001). Logistic regression analysis indicated that preoperative radiotherapy was a protective factor for deep cervical stromal invasion and vascular space invasion (P < 0.05). The median numbers of resected lymph nodes in the two groups were 18 and 19, separately. CONCLUSION: Preoperative radiotherapy can reduce both the incidence of deep cervical stromal invasion and vascular space invasion, but it cannot reduce lymph node positivity, parametrial involvement and positive surgical margins.
OBJECTIVE: To investigate the effect of preoperative radiotherapy or chemoradiotherapy combined with radical surgery on pathological outcomes in cervical cancerpatients. METHODS: Based on a large Chinese cervical cancer database of clinical diagnosis and treatment (C4 Project), the postoperative pathological outcomes of patients who received preoperative radiotherapy or chemoradiotherapy followed by open surgery (PR group) or surgery alone (SD group) were compared. RESULTS: Among the strictly selected patients, the incidence of lymph node metastasis in the PR group (n = 574) was higher than that in the SD group (231 VS 9; P < 0.001), while the incidence of vascular space invasion was lower than that in the SD group (72 VS 2041; P < 0.001). The logistic regression analysis showed that preoperative radiotherapy was a protective factor for parametrial involvement, positive surgical margins, deep cervical stromal invasion, and vascular space invasion (P < 0.05). The median number of resected lymph nodes in both groups was 18. After 1:1 case matching, the incidence of deep cervical stromal invasion and vascular space invasion was reduced by preoperative radiotherapy (292 vs 376, P < 0.001; 60 vs 106, P < 0.001). Logistic regression analysis indicated that preoperative radiotherapy was a protective factor for deep cervical stromal invasion and vascular space invasion (P < 0.05). The median numbers of resected lymph nodes in the two groups were 18 and 19, separately. CONCLUSION: Preoperative radiotherapy can reduce both the incidence of deep cervical stromal invasion and vascular space invasion, but it cannot reduce lymph node positivity, parametrial involvement and positive surgical margins.