Optimal pathological response indicated better long-term outcome among patients with stage IB2 to IIB cervical cancer submitted to neoadjuvant chemotherapy.
The role of pathological response in long-term outcome is still unclear in cervical cancer patients treated with neoadjuvant chemotherapy (NACT) in China. This study aimed to investigate the effect of optimal pathologic response (OPR) on survival in the patients treated with NACT and radical hysterectomy. First, 853 patients with stage IB2-IIB cervical cancer were included in a retrospective analysis; a Cox proportional hazards model was used to investigate the relationship between pathological response and disease-free survival (DFS). In the retrospective database, 64 (7.5%) patients were found to have achieved an OPR (residual disease <3 mm stromal invasion); in the multivariate Cox model, the risk of death was much greater in the non-OPR group than in the OPR group (HR, 2.61; 95%CI, 1.06 to 6.45; P = 0.037). Next, the role of OPR was also evaluated in a prospective cohort of 603 patients with cervical cancer. In the prospective cohort, 56 (9.3%) patients were found to have achieved an OPR; the log-rank tests showed that the risk of recurrence was higher in the non-OPR patients than in the OPR group (P = 0.05). After combined analysis, OPR in cervical cancer was found to be an independent prognostic factor for DFS.
Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China.
Kecheng
K
Huang
Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China.
Haiying
H
Sun
Department of Obstetrics and Gynecology, Wuhan General Hospital of Guangzhou Military Command, Wuhan, Hubei, 430070, China.
Zhilan
Z
Chen
Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China.|Department of Obstetrics and Gynecology, Wuhan Central Hospital, Wuhan, Hubei, 430014, China.
Xiong
X
Li
Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China.
ShaoShuai
S
Wang
Department of Orthopedics, Tai-He Hospital, Hubei University of Medicine, Shiyan, Hubei, 442000, China.
Xiaolin
X
Zhao
Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China.
Fangxu
F
Tang
Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China.
Yao
Y
Jia
Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China.
Ting
T
Hu
Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China.|Department of Obstetrics and Gynecology, Wuhan Central Hospital, Wuhan, Hubei, 430014, China.
Xiaofang
X
Du
Department of Internal Medicine, Luohe Renmin Hospital, the First Affiliated Hospital of Luohe Medical College, Luohe, Henan, 462000, China.
Haoran
H
Wang
Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China.|Tai-He Hospital, Hubei University of Medicine, Shiyan, Hubei, 442000, China.
Zhiyong
Z
Lu
Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China.
Jia
J
Huang
Department of Obstetrics and Gynecology, Renmin Hospital, Wuhan University, Wuhan, Hubei, 430000, China.
Juan
J
Gui
Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China.
Xiaoli
X
Wang
Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China.
Shasha
S
Zhou
Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China.
Lin
L
Wang
Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China.
Jincheng
J
Zhang
Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China.|Tai-He Hospital, Hubei University of Medicine, Shiyan, Hubei, 442000, China.
Lili
L
Guo
Henan Cancer Hospital, Zhengzhou, Henan, 450008, China.
Ru
R
Yang
Department of Obstetrics and Gynecology, Wuhan General Hospital of Guangzhou Military Command, Wuhan, Hubei, 430070, China.
Jian
J
Shen
Department of Obstetrics and Gynecology, Wuhan General Hospital of Guangzhou Military Command, Wuhan, Hubei, 430070, China.
Qinghua
Q
Zhang
Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China.
Shuang
S
Li
Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China.
Shixuan
S
Wang
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007044:Hysterectomy; D053208:Kaplan-Meier Estimate; D008207:Lymphatic Metastasis; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D018307:Neoplasms, Squamous Cell / Q000188:drug therapy* / Q000401:mortality / Q000556:secondary; D017671:Platinum Compounds / Q000627:therapeutic use*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012189:Retrospective Studies; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D055815:Young Adult
D000970:Antineoplastic Agents; D017671:Platinum Compounds