Treatment for locally resectable stage IIIC1r cervical cancer: surgery or chemoradiotherapy?

医学 宫颈癌 外科肿瘤学 阶段(地层学) 根治性子宫切除术 放化疗 根治性手术 外科 内科学 癌症 放射治疗 古生物学 生物
作者
Meiling Zhong,Yin-chuan Liu,Jian-tong Yang,Yanan Wang,Mei-hong Ao,Yun Xiao,Siyuan Zeng,Mei-rong Liang
出处
期刊:BMC Cancer [BioMed Central]
卷期号:24 (1) 被引量:1
标识
DOI:10.1186/s12885-024-11944-0
摘要

Abstract Objective The aim of this study was to compare the therapeutic value and treatment-related complications of radical hysterectomy with those of concurrent chemoradiotherapy (CCRT) for locally resectable (T1a2–T2a1) stage IIIC1r cervical cancer. Methods A total of 213 patients with locally resectable stage IIIC1r cervical cancer who had been treated at Jiangxi Maternal and Child Health Care Hospital between January 2013 and December 2021 were included in the study and classified into two groups: surgery (148 patients) and CCRT (65 patients). The disease-free survival (DFS) rate, overall survival (OS) rate, side effects, and economic costs associated with the two groups were compared. Results 43.9% (65/148) patients in the surgical group had no pelvic lymph node metastasis, and 21of them did not require supplementary treatment after surgery due to a low risk of postoperative pathology. The median follow-up time was 46 months (range: 7–108 months). The five-year DFS and OS rates of the surgery group were slightly higher than those of the CCRT group (80.7% vs. 75.1% and 81.6% vs. 80.6%, respectively; p > 0.05). The incidences of grade III–IV gastrointestinal reactions in the surgery and CCRT groups were 5.5% and 9.2%, respectively ( p = 0.332). Grade III–IV myelosuppression was identified in 27.6% of the surgery group and 26.2% of the CCRT group ( p = 0.836). The per capita treatment cost was higher for the surgery group than for the CCRT group (RMB 123, 918.6 0 vs. RMB 101, 880.90, p = 0.001). Conclusion The therapeutic effects and treatment-related complications of hysterectomy and CCRT are equivalent in patients with locally resectable stage IIIC1r cervical cancer, but surgery can provide accurate lymph node information and benefit patients with unnecessary radiation.
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