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Comparison between adjuvant chemotherapy and adjuvant radiotherapy/chemoradiotherapy after radical surgery in patients with cervical cancer: a meta-analysis

Journal of Gynecologic Oncology
2018년 29권 4호 p.62 ~ p.62
이광범 ( Lee Kwang-Beom ) - Gachon University College of Medicine Gachon University Gil Medical Center Department of Obstetrics and Gynecology

심승혁 ( Shim Seung-Hyuk ) - Konkuk University School of Medicine Department of Obstetrics and Gynecology
이종민 ( Lee Jong-Min ) - Kyung Hee University School of Medicine Kyung Hee University Hospital at Gangdong Department of Obstetrics and Gynecology

Abstract

Objective: To estimate the effect of adjuvant chemotherapy (AC) on the prognosis in cervical cancer patients with intermediate- or high-risk factors after radical hysterectomy (RH) compared to that for adjuvant radiotherapy (AR).

Methods: The Embase and MEDLINE databases and the Cochrane Library were searched for published studies comparing cervical cancer patients who received AC with those who received AR after RH. The endpoints were patient oncologic outcome. Random-effects meta-analytical models were used to calculate the pooled estimates of the effect of AC on mortality/recurrence.

Results: Two randomized trials and eleven observational studies (AC, 942 patients; AR, 1,721 patients) met our search criteria. There were no significant differences in mortality and any recurrence between two groups. The results for distant recurrence favored the AC group (pooled odds ratio: 0.69; 95% confidence interval: 0.54?0.88; p=0.03). In subgroup analyses (for study design, histology, indication for adjuvant treatment, AR type, AC type, and lymph node metastasis), there was no significant increase in mortality and recurrence for AC compared with that for AR.

Conclusion: Compared to AR, AC showed similar survival outcomes in cervical cancer patients undergoing RH and also appeared to reduce the risk of distant recurrence.

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