Download This Paper
Preprints with The Lancet is a collaboration between The Lancet Group of journals and SSRN to facilitate the open sharing of preprints for early engagement, community comment, and collaboration. Preprints available here are not Lancet publications or necessarily under review with a Lancet journal. These preprints are early-stage research papers that have not been peer-reviewed. The usual SSRN checks and a Lancet-specific check for appropriateness and transparency have been applied. The findings should not be used for clinical or public health decision-making or presented without highlighting these facts. For more information, please see the FAQs.
Outcomes of Definitive Concurrent Chemoradiotherapy for Cervical Squamous Cell Carcinoma and Adenocarcinoma: Overall Survival, Locoregional Recurrence, and Distant Metastasis
49 Pages Posted: 6 Aug 2020
More...Abstract
PURPOSE: To estimate the outcomes of definitive concurrent chemoradiotherapy (CCRT) for bulky or advanced-stage cervical squamous cell carcinoma (SCC) and adenocarcinoma (ADC).
PATIENTS AND METHODS: We enrolled patients who had been diagnosed as having cervical SCC or ADC and received definitive CCRT between January 1, 2007, and December 31, 2015. A Cox regression analysis was performed to determine the hazard ratio (HR) and 95% confidence intervals (95% CI); independent predictors were stratified or controlled for in the analysis, and the endpoint was all-cause mortality among patients with cervical SCC and ADC who received CCRT. Propensity score matching was performed to create well-balanced groups.
RESULTS: We enrolled 3258 patients who had International Federation of Gynecology and Obstetrics (FIGO) stage IB2–IVA cervical cancer without distant metastasis. Among them, 2927 patients with cervical SCC and 331 patients with cervical ADC received definitive CCRT. The results of multivariate Cox regression analysis indicated that ADC, advanced FIGO stage, no intracavitary brachytherapy, old age, earlier year of diagnosis, and higher comorbidity scores were significant independent poor prognostic factors of all-cause mortality in patients with cervical cancer who received definitive CCRT. Patients with cervical ADC who received definitive CCRT had higher all-cause mortality, locoregional recurrence (LRR), and distant metastasis (DM) (adjusted HR [95% CI]: 2.10 [1.79–2.46], 1.79 [1.35–2.37], and 1.97 [1.54–2.53] for all-cause mortality, LRR, and DM, respectively) compared with patients with cervical SCC who received CCRT.
CONCLUSION: Definitive CCRT in patients with cervical ADC resulted in lower overall survival, higher LRR, and higher DM rate compared with patients with cervical SCC.
Funding Statement: Lo-Hsu Medical Foundation, LotungPoh-Ai Hospital, supports SzuYuan Wu’s work (Funding Number: 10908 and 10909).
Declaration of Interests: The authors have no potential conflicts of interest to declare.
Ethics Approval Statement: Our protocols were reviewed and approved by the
Institutional Review Board of Taipei Medical University (TMU-JIRB No. 201712019).
Keywords: cervical cancer; squamous cell carcinoma; adenocarcinoma; concurrent chemoradiotherapy; survival
Suggested Citation: Suggested Citation