TY - JOUR
T1 - Adjuvant therapy in early-stage cervical cancer after radical hysterectomy: are we overtreating our patients? A meta-analysis
AU - Gómez-Hidalgo, Natalia R.
AU - Acosta, Úrsula
AU - Gómez Rodriguez, Tomás
AU - Mico, Soraya
AU - Verges, Ramona
AU - Bebia Conesa, Vicente
AU - Bradbury Lobato, Melissa
AU - Pérez-Hoyos, Santiago
AU - Pérez-Benavente, Assumpció
AU - Gil Moreno, Antonio
PY - 2022/8
Y1 - 2022/8
N2 - Objective: There is a gap in knowledge regarding the ideal management of patients with early-stage cervical cancer and intermediate-risk features. Here, we present a meta-analysis of the published literature on oncological outcomes in these patients and determine trends in postoperative management. Methods: MEDLINE and PubMed were used for literature searches. The inclusion criteria were: English language articles including ≥ 10 patients, patients who underwent radical hysterectomy, nodes negative, studies reporting oncological outcomes and complications treatment-related and compare a surgery-only cohort with a radiotherapy cohort. The PRISMA guidelines were followed. Combined relative risk was calculated using DerSimonian–Laird random-effects model and a forest plot was drawn. Results: We collected 183 manuscripts on early-stage cervical cancer treated with radical hysterectomy alone or with adjuvant radiotherapy after surgery. A total of eight studies met the inclusion criteria. Regarding oncological outcomes, survival was reported in five studies. The relative risk of recurrence and the relative risk of mortality was similar in both groups independently whether receive or not adjuvant therapy. Most of the studies did not report significant differences regarding morbidity treatment related between the groups, except for a higher rate of lymphedema after radiotherapy. Conclusion: We found that the relative risk of recurrence and mortality was similar in both groups not depending on adjuvant therapy. Therefore, whether radiotherapy adjuvant treatment is indicated remains a topic of debate. © 2022, The Author(s), under exclusive licence to Federación de Sociedades Españolas de Oncología (FESEO).
AB - Objective: There is a gap in knowledge regarding the ideal management of patients with early-stage cervical cancer and intermediate-risk features. Here, we present a meta-analysis of the published literature on oncological outcomes in these patients and determine trends in postoperative management. Methods: MEDLINE and PubMed were used for literature searches. The inclusion criteria were: English language articles including ≥ 10 patients, patients who underwent radical hysterectomy, nodes negative, studies reporting oncological outcomes and complications treatment-related and compare a surgery-only cohort with a radiotherapy cohort. The PRISMA guidelines were followed. Combined relative risk was calculated using DerSimonian–Laird random-effects model and a forest plot was drawn. Results: We collected 183 manuscripts on early-stage cervical cancer treated with radical hysterectomy alone or with adjuvant radiotherapy after surgery. A total of eight studies met the inclusion criteria. Regarding oncological outcomes, survival was reported in five studies. The relative risk of recurrence and the relative risk of mortality was similar in both groups independently whether receive or not adjuvant therapy. Most of the studies did not report significant differences regarding morbidity treatment related between the groups, except for a higher rate of lymphedema after radiotherapy. Conclusion: We found that the relative risk of recurrence and mortality was similar in both groups not depending on adjuvant therapy. Therefore, whether radiotherapy adjuvant treatment is indicated remains a topic of debate. © 2022, The Author(s), under exclusive licence to Federación de Sociedades Españolas de Oncología (FESEO).
KW - Adjuvant radiotherapy
KW - Cervical cancer surgery
KW - Early-stage cervical cancer
KW - Intermediate-risk factors
KW - Adjuvant radiotherapy
KW - Cervical cancer surgery
KW - Early-stage cervical cancer
KW - Intermediate-risk factors
KW - Adjuvant radiotherapy
KW - Cervical cancer surgery
KW - Early-stage cervical cancer
KW - Intermediate-risk factors
UR - http://dx.doi.org/10.1007/s12094-022-02808-9
U2 - 10.1007/s12094-022-02808-9
DO - 10.1007/s12094-022-02808-9
M3 - Article
SN - 1699-3055
VL - 24
SP - 1605
EP - 1614
JO - Clinical & Translational Oncology
JF - Clinical & Translational Oncology
IS - 8
ER -