Adjuvant therapy in early-stage cervical cancer after radical hysterectomy: are we overtreating our patients? A meta-analysis

Natalia R. Gómez-Hidalgo, Úrsula Acosta, Tomás Gómez Rodriguez, Soraya Mico, Ramona Verges, Vicente Bebia Conesa, Melissa Bradbury Lobato, Santiago Pérez-Hoyos, Assumpció Pérez-Benavente, Antonio Gil Moreno

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Resum

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).
Idioma originalAnglès
Pàgines (de-a)1605-1614
Nombre de pàgines10
RevistaClinical & Translational Oncology
Volum24
Número8
DOIs
Estat de la publicacióPublicada - d’ag. 2022

Keywords

  • Adjuvant radiotherapy
  • Cervical cancer surgery
  • Early-stage cervical cancer
  • Intermediate-risk factors

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