Natalia R Gómez-Hidalgo1, Úrsula Acosta2, Tomás Gómez Rodríguez3, Soraya Mico4, Ramona Verges4, Vicente Bebia Conesa2, Melissa Bradbury2, Santiago Pérez-Hoyos5, Asunción Pérez-Benavente2, Antonio Gil-Moreno2,6. 1. Unit of Gynecologic Oncology, Service of Gynecology, Vall d'Hebron Barcelona Hospital Campus, Autonoma University of Barcelona, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain. nrodriguez.gh@gmail.com. 2. Unit of Gynecologic Oncology, Service of Gynecology, Vall d'Hebron Barcelona Hospital Campus, Autonoma University of Barcelona, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain. 3. Gynecology Department, Virgen de la Victoria University Hospital, Málaga, Spain. 4. Radiotherapy Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain. 5. Statistics Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain. 6. Centro de Investigación Biomédica en Red de Cáncer, CIBERONC, Madrid, Spain.
Abstract
OBJECTIVE: There is a gap in knowledge regarding the ideal management of patients with early-stage cervical cancer and intermediate-risk features. Here, we present a meta-analysis of the published literature on oncological outcomes in these patients and determine trends in postoperative management. METHODS: MEDLINE and PubMed were used for literature searches. The inclusion criteria were: English language articles including ≥ 10 patients, patients who underwent radical hysterectomy, nodes negative, studies reporting oncological outcomes and complications treatment-related and compare a surgery-only cohort with a radiotherapy cohort. The PRISMA guidelines were followed. Combined relative risk was calculated using DerSimonian-Laird random-effects model and a forest plot was drawn. RESULTS: We collected 183 manuscripts on early-stage cervical cancer treated with radical hysterectomy alone or with adjuvant radiotherapy after surgery. A total of eight studies met the inclusion criteria. Regarding oncological outcomes, survival was reported in five studies. The relative risk of recurrence and the relative risk of mortality was similar in both groups independently whether receive or not adjuvant therapy. Most of the studies did not report significant differences regarding morbidity treatment related between the groups, except for a higher rate of lymphedema after radiotherapy. CONCLUSION: We found that the relative risk of recurrence and mortality was similar in both groups not depending on adjuvant therapy. Therefore, whether radiotherapy adjuvant treatment is indicated remains a topic of debate.
OBJECTIVE: There is a gap in knowledge regarding the ideal management of patients with early-stage cervical cancer and intermediate-risk features. Here, we present a meta-analysis of the published literature on oncological outcomes in these patients and determine trends in postoperative management. METHODS: MEDLINE and PubMed were used for literature searches. The inclusion criteria were: English language articles including ≥ 10 patients, patients who underwent radical hysterectomy, nodes negative, studies reporting oncological outcomes and complications treatment-related and compare a surgery-only cohort with a radiotherapy cohort. The PRISMA guidelines were followed. Combined relative risk was calculated using DerSimonian-Laird random-effects model and a forest plot was drawn. RESULTS: We collected 183 manuscripts on early-stage cervical cancer treated with radical hysterectomy alone or with adjuvant radiotherapy after surgery. A total of eight studies met the inclusion criteria. Regarding oncological outcomes, survival was reported in five studies. The relative risk of recurrence and the relative risk of mortality was similar in both groups independently whether receive or not adjuvant therapy. Most of the studies did not report significant differences regarding morbidity treatment related between the groups, except for a higher rate of lymphedema after radiotherapy. CONCLUSION: We found that the relative risk of recurrence and mortality was similar in both groups not depending on adjuvant therapy. Therefore, whether radiotherapy adjuvant treatment is indicated remains a topic of debate.
Authors: David Cibula; Richard Pötter; François Planchamp; Elisabeth Avall-Lundqvist; Daniela Fischerova; Christine Haie Meder; Christhardt Köhler; Fabio Landoni; Sigurd Lax; Jacob Christian Lindegaard; Umesh Mahantshetty; Patrice Mathevet; W Glenn McCluggage; Mary McCormack; Raj Naik; Remi Nout; Sandro Pignata; Jordi Ponce; Denis Querleu; Francesco Raspagliesi; Alexandros Rodolakis; Karl Tamussino; Pauline Wimberger; Maria Rosaria Raspollini Journal: Int J Gynecol Cancer Date: 2018-05 Impact factor: 3.437
Authors: Elizabeth A Kidd; Barry A Siegel; Farrokh Dehdashti; Janet S Rader; David G Mutch; Matthew A Powell; Perry W Grigsby Journal: J Clin Oncol Date: 2010-03-22 Impact factor: 44.544