Comparison of oncological outcomes between radical hysterectomy and radiochemotherapy for International Federation of Gynecology and Obstetrics 2018 stage IIIC1 cervical adenocarcinoma: A retrospective multicenter cohort study

IF 1.6 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of Obstetrics and Gynaecology Research Pub Date : 2025-05-12 DOI:10.1111/jog.16307

Zhenwei Gao, Zhaohong Yin, Lixin Sun, Hongwei Zhao, Chunlin Chen, Ping Liu

{"title":"Comparison of oncological outcomes between radical hysterectomy and radiochemotherapy for International Federation of Gynecology and Obstetrics 2018 stage IIIC1 cervical adenocarcinoma: A retrospective multicenter cohort study","authors":"Zhenwei Gao, Zhaohong Yin, Lixin Sun, Hongwei Zhao, Chunlin Chen, Ping Liu","doi":"10.1111/jog.16307","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>To compare oncological outcomes of radical hysterectomy (RH) and radiochemotherapy (R-CT) for stage IIIC1 (FIGO 2018) cervical adenocarcinoma patients.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Based on the Chinese Cervical Cancer Clinical Diagnosis and Treatment Project Database, we retrospectively reviewed 236 cases of FIGO stage IIIC1 cervical adenocarcinoma diagnosed between 2005 and 2019. The 5-year overall survival (OS) and 5-year disease-free survival (DFS) rates were compared between the two treatment groups using multivariate Cox regression models and the log-rank test, both in the overall study population and after propensity score matching (PSM).</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>From 63 926 patients, we selected 236 cases, including 203 in the RH group and 33 in the R-CT group. In the overall study population, R-CT was associated with significantly worse 5-year OS (51.8% vs. 67.2%, <i>p</i> < 0.05) and 5-year DFS (43.1% vs. 60.1%, <i>p</i> < 0.05) compared to RH. Multivariate analysis revealed that R-CT was an independent risk factor for 5-year DFS (hazard ratio [HR] = 2.226, 95% confidence interval [CI] 1.141–4.343, <i>p</i> < 0.05) but not for 5-year OS (HR = 1.834, 95% CI: 0.829–4.061, <i>p</i> > 0.05) in FIGO stage IIIC1 cervical adenocarcinoma. After matching (<i>n</i> = 26 in R-CT group vs. 73 in RH group), the R-CT group showed significantly lower 5-year OS (50.3% vs. 77.4%, <i>p</i> < 0.05) and DFS (38.2% vs. 65.0%, <i>p</i> < 0.05) compared to the RH group. In the matched cohort, R-CT remained an independent risk factor for 5-year DFS (HR = 2.299, 95% CI: 1.113–4.750, <i>p</i> < 0.05) but not for 5-year OS (HR = 1.926, 95% CI: 0.792–4.682, <i>p</i> > 0.05).</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>Among patients with stage FIGO 2018 IIIC1 cervical cancer adenocarcinoma, R-CT was not associated with better oncological outcomes than RH. Radiotherapy should not be the only recommended treatment.</p>\n </section>\n </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 5","pages":""},"PeriodicalIF":1.6000,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Obstetrics and Gynaecology Research","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/jog.16307","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background

To compare oncological outcomes of radical hysterectomy (RH) and radiochemotherapy (R-CT) for stage IIIC1 (FIGO 2018) cervical adenocarcinoma patients.

Methods

Based on the Chinese Cervical Cancer Clinical Diagnosis and Treatment Project Database, we retrospectively reviewed 236 cases of FIGO stage IIIC1 cervical adenocarcinoma diagnosed between 2005 and 2019. The 5-year overall survival (OS) and 5-year disease-free survival (DFS) rates were compared between the two treatment groups using multivariate Cox regression models and the log-rank test, both in the overall study population and after propensity score matching (PSM).

Results

From 63 926 patients, we selected 236 cases, including 203 in the RH group and 33 in the R-CT group. In the overall study population, R-CT was associated with significantly worse 5-year OS (51.8% vs. 67.2%, p < 0.05) and 5-year DFS (43.1% vs. 60.1%, p < 0.05) compared to RH. Multivariate analysis revealed that R-CT was an independent risk factor for 5-year DFS (hazard ratio [HR] = 2.226, 95% confidence interval [CI] 1.141–4.343, p < 0.05) but not for 5-year OS (HR = 1.834, 95% CI: 0.829–4.061, p > 0.05) in FIGO stage IIIC1 cervical adenocarcinoma. After matching (n = 26 in R-CT group vs. 73 in RH group), the R-CT group showed significantly lower 5-year OS (50.3% vs. 77.4%, p < 0.05) and DFS (38.2% vs. 65.0%, p < 0.05) compared to the RH group. In the matched cohort, R-CT remained an independent risk factor for 5-year DFS (HR = 2.299, 95% CI: 1.113–4.750, p < 0.05) but not for 5-year OS (HR = 1.926, 95% CI: 0.792–4.682, p > 0.05).

Conclusion

Among patients with stage FIGO 2018 IIIC1 cervical cancer adenocarcinoma, R-CT was not associated with better oncological outcomes than RH. Radiotherapy should not be the only recommended treatment.

查看原文本刊更多论文

国际妇产科联合会2018年IIIC1期宫颈腺癌根治性子宫切除术与放化疗的肿瘤预后比较：一项回顾性多中心队列研究

背景：比较IIIC1期（FIGO 2018）宫颈腺癌患者根治性子宫切除术（RH）和放化疗（R-CT）的肿瘤预后。方法基于中国宫颈癌临床诊疗项目数据库，回顾性分析2005 - 2019年诊断的236例FIGO IIIC1期宫颈腺癌。采用多变量Cox回归模型和log-rank检验，比较两个治疗组在总体研究人群和倾向评分匹配（PSM）后的5年总生存率（OS）和5年无病生存率（DFS）。结果从63 926例患者中筛选出236例，其中RH组203例，R-CT组33例。在整个研究人群中，与RH相比，R-CT与5年OS （51.8% vs. 67.2%, p < 0.05）和5年DFS （43.1% vs. 60.1%, p < 0.05）相关。多因素分析显示，R-CT是FIGO IIIC1期宫颈腺癌5年DFS的独立危险因素（风险比[HR] = 2.226, 95%可信区间[CI] 1.141 ~ 4.343, p < 0.05），但不是5年OS的独立危险因素（风险比[HR] = 1.834, 95% CI: 0.829 ~ 4.061, p > 0.05）。配对后（R-CT组为26例，RH组为73例），R-CT组5年OS（50.3%比77.4%,p < 0.05）和DFS（38.2%比65.0%,p < 0.05）明显低于RH组。在匹配的队列中，R-CT仍然是5年DFS的独立危险因素（HR = 2.299, 95% CI: 1.113-4.750, p > 0.05），但不是5年OS的独立危险因素（HR = 1.926, 95% CI: 0.792-4.682, p > 0.05）。结论在FIGO 2018 IIIC1期宫颈癌腺癌患者中，R-CT与肿瘤预后的相关性不优于RH。放疗不应是唯一推荐的治疗方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of Obstetrics and Gynaecology Research 医学-妇产科学

CiteScore

3.10

自引率

0.00%

发文量

376

审稿时长

3-6 weeks

期刊介绍： The Journal of Obstetrics and Gynaecology Research is the official Journal of the Asia and Oceania Federation of Obstetrics and Gynecology and of the Japan Society of Obstetrics and Gynecology, and aims to provide a medium for the publication of articles in the fields of obstetrics and gynecology. The Journal publishes original research articles, case reports, review articles and letters to the editor. The Journal will give publication priority to original research articles over case reports. Accepted papers become the exclusive licence of the Journal. Manuscripts are peer reviewed by at least two referees and/or Associate Editors expert in the field of the submitted paper.