Impact of neoadjuvant chemotherapy on the postoperative pathology of locally advanced cervical squamous cell carcinomas: 1:1 propensity score matching analysis |
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| Institution: | 1. Department of Obstetrics and Gynecology, Nan Fang Hospital, Southern Medical University, Guangzhou, Guangdong, China;2. Department of Obstetrics and Gynecology, Second Hospital of Shanxi Medical University, Taiyuan, Shangxi, China;3. Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Zhengzhou University, Henan, China;4. Department of Gynecology, Fourth Hospital, Hebei Medical University, Shijiazhuang, China;5. Department of Obstetrics and Gynecology, Daping Hospital, Army Medical University, Chonqing, China;6. Department of Obstetrics and Gynecology, Xinqiao Hospital, Army Medical University, Chongqing, China;7. Department of Obstetrics and Gynecology, Yuncheng Central Hospital, Yuncheng, China;8. Department of Gynaecology, Anhui Cancer Hospital, HeFei, China;9. Department of Gynecology, The Maternity and Child Care Hospital of Guizhou Province, Guiyang, China;10. Department of Obstetrics and Gynecology, China-Japan Friendship Hospital, Beijing, China;11. Department of Obstetrics and Gynecology, Guizhou Provincial People’s Hospital, Guiyang, China;12. Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Beijing, China;1. Sarcoma, Melanoma and Rare Tumors Surgery Unit, Humanitas Clinical and Research Center – IRCCS, Via Manzoni 56, 20089, Rozzano, Milan, Italy;2. Department of Biomedical Sciences, Humanitas University, 20090, Pieve Emanuele, Milan, Italy;3. Pathology Unit, Humanitas Clinical and Research Center – IRCCS, Via Manzoni 56, 20089, Rozzano, Milan, Italy;4. Oncology Unit, Humanitas Clinical and Research Center – IRCCS, Via Manzoni 56, 20089, Rozzano, Milan, Italy;5. Neuroradiology Unit, Humanitas Clinical and Research Center – IRCCS, Via Manzoni 56, 20089, Rozzano, Milan, Italy;1. Fondazione Policlinico Universitario A. Gemelli, IRCCS, UOC Ginecologia Oncologica, Dipartimento per la salute della Donna e del Bambino e della Salute Pubblica, Roma, Italy;2. Northern Gynaecological Oncology Center, Queen Elizabeth Hospital, Gateshead, United Kingdom;3. Gemelli Molise, Dipartimento di Oncologia, UOC Ginecologia Oncologica, Campobasso, Italy;4. Gynecology and Brest Care Unit, Mater Olbia Hospital, Olbia, Italy;5. Department of Gynecologic Oncology, University of Palermo, Palermo, Italy;6. Università Cattolica del Sacro Cuore, Roma, Italy;1. Amsterdam UMC, University of Amsterdam, Department of Biomedical Engineering & Physics, Cancer Center Amsterdam, Amsterdam, The Netherlands;2. Amsterdam UMC, University of Amsterdam, Department of Surgery, Cancer Center Amsterdam, Amsterdam, The Netherlands;3. Amsterdam UMC, University of Amsterdam, Department of Plastic, Reconstructive & Hand Surgery, Amsterdam, The Netherlands;4. Amsterdam UMC, University of Amsterdam, Department of Anesthesiology, Cancer Center Amsterdam, Amsterdam, The Netherlands;5. Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, Amsterdam Cardiovascular Sciences, Department of Biomedical Engineering and Physics, Amsterdam, The Netherlands;6. Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, Department of Urology, Amsterdam, The Netherlands;1. Department of Gynecology and Obstetrics, University of Parma, Parma, Italy;2. Department of Obstetrics and Gynecology, Ospedale Degli Infermi, ASL Biella, Biella, Italy;3. Department of Gynecologic Oncology, ARNAS Civico Hospital of Palermo, Palermo, Italy;4. Department of Obstetrics & Gynecology, Gynecologic Oncology and Minimally Invasive Pelvic Surgery, IRCCS Sacro Cuore Don Calabria Hospital, Negrar (Verona), International School of Surgical Anatomy, Italy;5. Department of Obstetrics and Gynecology, University of Verona, Verona, Italy;1. Unit of General and Upper GI Surgery, University of Verona, Verona, Italy;2. Unit of Epidemiology & Medical Statistics, Dept. of Diagnostics & Public Health, University of Verona, Verona, Italy;3. Department of Upper Gastrointestinal Surgery, Royal Marsden Hospital, London, UK;1. Department of Urology, Caritas St. Josef Hospital, University of Regensburg, Landshuterstr. 65, 93053, Regensburg, Germany;2. Department of Surgical Oncology (Urology), Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066, CX, Amsterdam, the Netherlands;3. Experimental Medicine and Therapy Research, University of Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany |
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| Abstract: | ObjectiveTo assess the impact of neoadjuvant chemotherapy on postoperative pathology for stage IB2 and IIA2 cervical squamous cell carcinoma.MethodsPostoperative pathology was compared between patients who received neoadjuvant chemotherapy followed by radical hysterectomy (NACT group) and patients who received upfront radical hysterectomy (URH group). Then, patients in the NACT group were divided into a chemotherapy-sensitive group and a chemotherapy-insensitive group according to their response to chemotherapy.ResultsAfter 1:1 propensity score matching (PSM), the positive rates of lymphovascular space invasion (LVSI) (7.9% vs 17.7%, P = 0.001) and cervical deep stromal invasion (60.4% vs 76.2%, P < 0.001) in the NACT group were significantly lower than those in the URH group, while the positive rates of parametrial invasion, lymph node metastasis, and vaginal margin invasion were not significantly different between the two groups. The rate of positive lymph node metastasis in the chemotherapy-sensitive group was significantly lower than that in the URH group (18.1% vs 26.5%, P = 0.037).ConclusionAmong patients with stage IB2 and IIA2 cervical squamous cell carcinomas, NACT can reduce the positive rate of intermediate-risk factors, such as deep cervical stromal invasion and LVSI, but cannot reduce the positive rate of high-risk factors. For patients who are chemotherapy sensitive, NACT can reduce the positive rate of lymph node metastasis. |
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| Keywords: | Neoadjuvant chemotherapy Locally advanced Cervical squamous cell carcinomas Postoperative pathology |
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