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Efficacy of neoadjuvant chemotherapy in patients with FIGO stage IB1 to IIA cervical cancer: an international collaborative meta-analysis.

DC Field Value Language
dc.contributor.authorKim, HS-
dc.contributor.authorSardi, JE-
dc.contributor.authorKatsumata, N-
dc.contributor.authorRyu, HS-
dc.contributor.authorNam, JH-
dc.contributor.authorChung, HH-
dc.contributor.authorPark, NH-
dc.contributor.authorSong, YS-
dc.contributor.authorBehtash, N-
dc.contributor.authorKamura, T-
dc.contributor.authorCai, HB-
dc.contributor.authorKim, JW-
dc.date.accessioned2014-05-29-
dc.date.available2014-05-29-
dc.date.issued2013-
dc.identifier.issn0748-7983-
dc.identifier.urihttp://repository.ajou.ac.kr/handle/201003/10231-
dc.description.abstractBACKGROUND: The efficacy of neoadjuvant chemotherapy before surgery (NCS) has not been well-established in FIGO stage IB1 to IIA cervical cancer when compared with primary surgical treatment (PST). Thus, we performed a meta-analysis to determine the efficacy of NCS in patients with FIGO stage IB1 to IIA cervical cancer when compared with PST.



METHODS: We searched Pubmed, Embase and the Cochrane Library between January 1987 and September 2010. Since there was a relative lack of relevant randomized controlled trials (RCTs), we included 5 RCTs and 4 observational studies involving 1784 patients among 523 potentially relevant studies.



RESULTS: NCS was related with lower rates of large tumor size (≥4 cm) (ORs, 0.22 and 0.10; 95% CI, 0.13-0.39 and 0.02-0.37) and lymph node metastasis (ORs, 0.61 and 0.38; 95% CI, 0.37-0.99 and 0.20-0.73) than PST in all studies and RCTs. Furthermore, NCS reduced the need of adjuvant radiotherapy (RT) in all studies (OR, 0.57; 95% CI, 0.33-0.98), and distant metastasis in all studies and RCTs (ORs, 0.61 and 0.61; 95% CI, 0.42-0.89 and 0.38-0.97). However, overall and loco-regional recurrences and progression-free survival were not different between the 2 treatments. On the other hand, NCS was associated with poorer overall survival in observational studies when compared with PST (HR, 1.68; 95% CI, 1.12-2.53).



CONCLUSIONS: Although NCS reduced the need of adjuvant RT by decreasing tumor size and lymph node metastasis, and distant metastasis, it failed to improve survival when compared with PST in patients with FIGO stage IB1 to IIA cervical cancer.
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dc.language.isoen-
dc.subject.MESHAntineoplastic Combined Chemotherapy Protocols/*therapeutic use-
dc.subject.MESHChemotherapy, Adjuvant-
dc.subject.MESHDisease-Free Survival-
dc.subject.MESHFemale-
dc.subject.MESHHumans-
dc.subject.MESHHysterectomy-
dc.subject.MESHInternational Cooperation-
dc.subject.MESHLymphatic Metastasis-
dc.subject.MESHNeoadjuvant Therapy/*methods-
dc.subject.MESHNeoplasm Recurrence, Local/prevention & control-
dc.subject.MESHNeoplasm Staging-
dc.subject.MESHObservation-
dc.subject.MESHOdds Ratio-
dc.subject.MESHRadiotherapy, Adjuvant-
dc.subject.MESHRandomized Controlled Trials as Topic-
dc.subject.MESHResearch Design-
dc.subject.MESHRisk Factors-
dc.subject.MESHTreatment Outcome-
dc.subject.MESHUterine Cervical Neoplasms/*drug therapy/*pathology/radiotherapy/surgery-
dc.titleEfficacy of neoadjuvant chemotherapy in patients with FIGO stage IB1 to IIA cervical cancer: an international collaborative meta-analysis.-
dc.typeArticle-
dc.identifier.pmid23084091-
dc.identifier.urlhttp://linkinghub.elsevier.com/retrieve/pii/S0748-7983(12)01266-8-
dc.contributor.affiliatedAuthor유, 희석-
dc.type.localJournal Papers-
dc.identifier.doi10.1016/j.ejso.2012.09.003-
dc.citation.titleEuropean journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology-
dc.citation.volume39-
dc.citation.number2-
dc.citation.date2013-
dc.citation.startPage115-
dc.citation.endPage124-
dc.identifier.bibliographicCitationEuropean journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology, 39(2):115-124, 2013-
dc.identifier.eissn1532-2157-
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Journal Papers > School of Medicine / Graduate School of Medicine > Obstetrics & Gynecology
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