Survival of stage I B cervical cancer patients receiving neoadjuvant chemotherapy: A meta-analysis
10.3781/j.issn.1000-7431.2018.33.659
- Author:
Ting HU
1
Author Information
1. Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology
- Publication Type:Journal Article
- Keywords:
Cervical neoplasms;
Meta-analysis;
Neoadjuvant chemotherapy;
Prognosis
- From:
Tumor
2018;38(2):126-132
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To determine the effect of neoadjuvant chemotherapy on the overall survival (OS) in patients with International Federation of Gynecology and Obstetrics (IFGO) stage I B cervical cancer. Methods: The randomized controlled trials and retrospective casecontrol studies on neoadjuvant chemotherapy plus radical surgery vs initial radical surgery in patients with IFGO stage I B cervical cancer were searched in PubMed, EMBASE and CENTRAL (Cochrane Central Register of Controlled Trials) databases, and the subgroup analysis was performed according to the type of the study. The hazard ratio (HR) and 95% confidence interval (CI) were used to describe the effect of neoadjuvant chemotherapy on OS of FIGO stage I B cervical cancer patients. The quality of randomized controlled trials was evaluated by Cochrane Collaboration's tool for assessing the risk of bias. The quality of retrospective studies was evaluated according to the Newcastle-Ottawa Scale (NOS) scoring system. The publication bias was tested. Results: Three randomized controlled trials and three retrospective observational studies involving 1 080 stage I B patients with cervical cancer were included in this Meta-analysis. The combined HR estimate of OS for stage I B patients with cervical cancer receiving neoadjuvant chemotherapy plus surgery was 0.71 (95% CI: 0.55-0.93) using fixed effect model. In Meta-analysis of randomized controlled trials, the combined HR estimate of OS for stage I B patients with cervical cancer receiving neoadjuvant chemotherapy plus surgery was 0.77 (95% CI: 0.58-1.03) using fixed effect model. In Meta-analysis of retrospective observational studies, the combined HR estimate of OS for stage I B patients with cervical cancer receiving neoadjuvant chemotherapy plus surgery was 0.45 (95% CI: 0.23-0.88). The funnel map showed no publication bias. Conclusion: Neoadjuvant chemotherapy can significantly improve the OS of stage I B cervical cancer patients. Additional randomized controlled studies with large-scale sample are needed to verify this survival beneft.
