Shinya Matsuzaki1, Maximilian Klar2, Mikio Mikami3, Muneaki Shimada4, Brendan H Grubbs5, Keiichi Fujiwara6, Lynda D Roman1,7, Koji Matsuo8,9. 1. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, 2020 Zonal Avenue IRD520, Los Angeles, CA, 90033, USA. 2. Department of Obstetrics and Gynecology, University of Freiburg, Freiburg, Germany. 3. Department of Obstetrics and Gynecology, Tokai University School of Medicine, Isehara, Kanagawa, Japan. 4. Department of Obstetrics and Gynecology, Tohoku University School of Medicine, Sendai, Miyagi, Japan. 5. Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA. 6. Department of Gynecologic Oncology, Saitama Medical University International Medical Center, Saitama, Japan. 7. Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA. 8. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, 2020 Zonal Avenue IRD520, Los Angeles, CA, 90033, USA. koji.matsuo@med.usc.edu. 9. Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA. koji.matsuo@med.usc.edu.
Abstract
PURPOSE OF REVIEW: To review and discuss the present evidence of surgery- and radiation-based treatment strategies for stage IIB cervical cancer. RECENT FINDINGS: Recently, two randomized controlled trials compared the efficacy of neoadjuvant chemotherapy followed by radical hysterectomy (NACT + RH) with that of concurrent chemoradiotherapy (CCRT) for stage IB3-IIB cervical cancer. When these studies were combined (N = 1259), NACT + RH was associated with a shorter disease-free survival [hazard ratio (HR) 1.36, 95% confidence interval (CI) 1.13-1.64], but with a similar overall survival (HR 1.11, 95% CI 0.90-1.36) when compared with the findings for CCRT. Stage-specific analysis for stage IIB cervical cancer demonstrated that disease-free survival was significantly worse with NACT + RH than with CCRT (HR 1.90, 95% CI 1.25-2.89); however, no significant difference was observed for stage IB3-IIA cervical cancer. Based on the results of recent level I evidence, the standard treatment for stage IIB cervical cancer remains CCRT.
PURPOSE OF REVIEW: To review and discuss the present evidence of surgery- and radiation-based treatment strategies for stage IIB cervical cancer. RECENT FINDINGS: Recently, two randomized controlled trials compared the efficacy of neoadjuvant chemotherapy followed by radical hysterectomy (NACT + RH) with that of concurrent chemoradiotherapy (CCRT) for stage IB3-IIB cervical cancer. When these studies were combined (N = 1259), NACT + RH was associated with a shorter disease-free survival [hazard ratio (HR) 1.36, 95% confidence interval (CI) 1.13-1.64], but with a similar overall survival (HR 1.11, 95% CI 0.90-1.36) when compared with the findings for CCRT. Stage-specific analysis for stage IIB cervical cancer demonstrated that disease-free survival was significantly worse with NACT + RH than with CCRT (HR 1.90, 95% CI 1.25-2.89); however, no significant difference was observed for stage IB3-IIA cervical cancer. Based on the results of recent level I evidence, the standard treatment for stage IIB cervical cancer remains CCRT.
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