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Treatment outcomes of locally advanced cervical cancer by histopathological types in a single institution: A propensity score matching study
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Treatment outcomes of locally advanced cervical cancer by histopathological types in a single institution: A propensity score matching study

Kuang-Cheng Yin, Chien-Hsing Lu, Jin-Ching Lin, Chiann-Yi HsuLily Wang
Journal of the Formosan Medical Association, 卷.117(10), 頁碼.922-931
10/2018
PMID: 30025761

摘要

Adenocarcinoma Adenosquamous Carcinoma Chemoradiotherapy Propensity score matching Uterine cervical neoplasms Medicine (all)
Background: In the current National Comprehensive Cancer Network (NCCN) guidelines, the standard treatment methods revealed no difference between locally advanced cervical (LAC) adenocarcinoma/adenosquamous carcinoma (AC/ASC) and LAC squamous cell carcinoma (SCC). The aim of this study was to compare the treatment outcomes of LAC AC/ASC with LAC SCC through the propensity score matching (PSM) analysis. Methods: This retrospective study enrolled 181 LAC cancer patients who were treated with intensity modulated radiotherapy/volumetric modulated arc therapy and concurrent weekly cisplatin 30–40 mg/m <sup>2</sup> . In total, there were 151 LAC SCC patients and 30 LAC AC/ASC patients. The endpoints were overall survival (OS), disease-free survival (DFS), locoregional failure-free survival (LRFFS), and distant metastasis-free survival (DMFS). A 1:1 ratio PSM analysis was performed using the nearest neighbor method with a caliper of 0.20. Treatment outcomes were compared between 30 matched LAC SCC patients and 30 LAC AC/ASC patients. Results: Before a 1:1 ratio PSM, the 5-year OS, DFS, LRFFS, and DMFS in the LAC SCC group were 78.6%, 71.3%, 88.2%, and 76.2%, respectively. After a 1:1 ratio PSM, the 5-year OS, DFS, LRFFS, and DMFS in the LAC AC/ASC group were 46.0%, 43.3%, 70.0%, and 45.4%, respectively, which were all significantly inferior than the rates of 90.0%, 75.8%, 96.6%, and 78.8% in the matched LAC SCC group, respectively (p < 0.05). Conclusion: LAC AC/ASC carries a poorer prognosis than LAC SCC. LAC AC/ASC needs more aggressive treatment in order to achieve higher OS and DFS.

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https://doi.org/10.1016/j.jfma.2018.07.002檢視
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