Yang Shu-Li, Chen Ling, He Yue, Zhao Hui, Wu Yu-Mei
Department of Gynecological Oncology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China.
Guangzhou Red Cross Hospital, Guangzhou, China.
J Int Med Res. 2020 Aug;48(8):300060520945507. doi: 10.1177/0300060520945507.
In this meta-analysis, we aimed to evaluate the oncological outcomes of preoperative neoadjuvant chemotherapy followed by radical surgery compared with radical surgery alone for treatment of International Federation of Gynecology and Obstetrics (FIGO) stage I-II cervical cancer.
We searched for studies comparing the safety and efficacy of neoadjuvant chemotherapy plus surgery versus surgery alone in treatment outcomes of locally advanced cervical cancer. Meta-analysis was used to calculate the pooled odds ratios with corresponding 95% confidence intervals (CI).
Sixteen studies were included in our analysis. Pooled analysis of overall survival rate [odds ratio (OR) = 1.09, 95% CI: 0.83-1.43] and progression-free survival rate (OR = 1.10, 95% CI: 0.77-1.57) showed that preoperative neoadjuvant chemotherapy did not have a benefit compared with surgery alone in terms of survival rates. The pooled results for postoperative parameters indicated that preoperative neoadjuvant chemotherapy followed by radical surgery was associated with a high rate of vascular space involvement (OR = 0.25, 95% CI: 0.17-0.35) and parametrial infiltration (OR = 0.60, 95% CI: 0.45-0.79).
This meta-analysis indicated that surgery following neoadjuvant chemotherapy for FIGO stage I-II cervical cancer and surgery alone had similar oncological outcomes.
在这项荟萃分析中，我们旨在评估与单纯根治性手术相比，术前新辅助化疗后再行根治性手术治疗国际妇产科联盟（FIGO）I-II期宫颈癌的肿瘤学结局。
我们检索了比较新辅助化疗联合手术与单纯手术在局部晚期宫颈癌治疗结局方面的安全性和有效性的研究。采用荟萃分析计算合并比值比及相应的95%置信区间（CI）。
我们的分析纳入了16项研究。总生存率[比值比（OR）=1.09，95%CI：0.83-1.43]和无进展生存率（OR=1.10，95%CI：0.77-1.57）的合并分析表明，术前新辅助化疗与单纯手术相比，在生存率方面并无优势。术后参数的合并结果表明，术前新辅助化疗后再行根治性手术与较高的脉管间隙受累率（OR=0.25，95%CI：0.17-0.35）和宫旁浸润率（OR=0.60，95%CI：0.45-0.79）相关。
这项荟萃分析表明，FIGO I-II期宫颈癌新辅助化疗后手术与单纯手术的肿瘤学结局相似。
