Chemo-radiotherapy after neoadjuvant chemotherapy and radical hysterectomy in women with stage IB-IIB cervical cancer: Do we need to change the therapeutic approach? A cohort study
Background: Chemoradiotherapy is recommended as the standard treatment for advanced cervical cancer, and neoadjuvant chemotherapy (NACT) can be beneficial for patients on long radiotherapy waiting lists. This study aimed to evaluate the need for chemoradiotherapy after NACT and radical hysterectomy...
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| Language: | English |
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Elsevier
2025-06-01
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| Series: | Surgery in Practice and Science |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666262025000130 |
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| author | Somayeh Nikfar Azam Sadat Mousavi Setareh Akhavan Shahrzad Sheikhhasani Amir Almasi-Hashiani Ramin Parvizrad Narges Zamani |
| author_facet | Somayeh Nikfar Azam Sadat Mousavi Setareh Akhavan Shahrzad Sheikhhasani Amir Almasi-Hashiani Ramin Parvizrad Narges Zamani |
| author_sort | Somayeh Nikfar |
| collection | DOAJ |
| description | Background: Chemoradiotherapy is recommended as the standard treatment for advanced cervical cancer, and neoadjuvant chemotherapy (NACT) can be beneficial for patients on long radiotherapy waiting lists. This study aimed to evaluate the need for chemoradiotherapy after NACT and radical hysterectomy in women with stage IB-IIB cervical cancer. Methods: This was a retrospective, cohort study. All patients in the gynecologic oncology clinic of Imam Khomeini Hospital, Tehran, Iran, who were diagnosed with stage IB-IIB cervical cancer and treated with NACT and radical hysterectomy between 2010 and 2020, were included in this study. The records of all the patients who met the inclusion criteria were evaluated during the study period. Outcomes of interest and progression-free survival (PFS) were also assessed. Results: In this study, the clinical files of 613 patients with cervical cancer were studied, and among them, 63 patients (10.2%) underwent NACT. Eighteen patients (33.3%) did not require another treatment modality after chemotherapy and radical hysterectomy, while 66.7% (36 cases) of patients required chemoradiotherapy after NACT and radical hysterectomy, and recurrence was observed in 11.6% (5 cases) of patients. The 1-, 5- and 10-year PFS rate was 97.6% (95% CI: 84.2–99.6), 89.5% (95% CI: 74.4–95.9) and 89.5% (95% CI: 74.4–95.9), respectively. Conclusions: It can be concluded that a significant percentage of patients who are candidates for NACT followed by radical hysterectomy would require another modality of treatment, which is chemoradiotherapy; therefore, it is recommended that by conducting prospective studies, in addition to investigating this issue, the choice of the first method of patient treatment in these stages should be reconsidered so that patients do not suffer from two treatments and related complications, and undergo chemoradiotherapy from the beginning. |
| format | Article |
| id | doaj-art-c5cbd20b8d1c47cf8133ca459458516d |
| institution | DOAJ |
| issn | 2666-2620 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Surgery in Practice and Science |
| spelling | doaj-art-c5cbd20b8d1c47cf8133ca459458516d2025-08-20T03:21:15ZengElsevierSurgery in Practice and Science2666-26202025-06-012110028410.1016/j.sipas.2025.100284Chemo-radiotherapy after neoadjuvant chemotherapy and radical hysterectomy in women with stage IB-IIB cervical cancer: Do we need to change the therapeutic approach? A cohort studySomayeh Nikfar0Azam Sadat Mousavi1Setareh Akhavan2Shahrzad Sheikhhasani3Amir Almasi-Hashiani4Ramin Parvizrad5Narges Zamani6Department of Obstetrics and Gynecology, Taleghani Hospital, Arak University of Medical Sciences, Arak, IranDepartment of Oncologic Gynecology, Vali-Asr Hospital, Imam Khomeini Hospital Complex (IKHC) Tehran University of Medical Sciences, Tehran, Iran; Corresponding authors at: Department of Oncologic Gynecology, Vali-Asr Hospital, Imam Khomeini Hospital Complex (IKHC) Tehran University of Medical Sciences, Keshavarz Blvd., Tehran, Iran.Department of Oncologic Gynecology, Vali-Asr Hospital, Imam Khomeini Hospital Complex (IKHC) Tehran University of Medical Sciences, Tehran, IranDepartment of Oncologic Gynecology, Vali-Asr Hospital, Imam Khomeini Hospital Complex (IKHC) Tehran University of Medical Sciences, Tehran, IranDepartment of Epidemiology, Arak University of Medical Sciences, Arak, IranDepartment of Emergency Medicine, Arak University of Medical Sciences, Vali-Asr Hospital, Arak, IranDepartment of Oncologic Gynecology, Vali-Asr Hospital, Imam Khomeini Hospital Complex (IKHC) Tehran University of Medical Sciences, Tehran, Iran; Corresponding authors at: Department of Oncologic Gynecology, Vali-Asr Hospital, Imam Khomeini Hospital Complex (IKHC) Tehran University of Medical Sciences, Keshavarz Blvd., Tehran, Iran.Background: Chemoradiotherapy is recommended as the standard treatment for advanced cervical cancer, and neoadjuvant chemotherapy (NACT) can be beneficial for patients on long radiotherapy waiting lists. This study aimed to evaluate the need for chemoradiotherapy after NACT and radical hysterectomy in women with stage IB-IIB cervical cancer. Methods: This was a retrospective, cohort study. All patients in the gynecologic oncology clinic of Imam Khomeini Hospital, Tehran, Iran, who were diagnosed with stage IB-IIB cervical cancer and treated with NACT and radical hysterectomy between 2010 and 2020, were included in this study. The records of all the patients who met the inclusion criteria were evaluated during the study period. Outcomes of interest and progression-free survival (PFS) were also assessed. Results: In this study, the clinical files of 613 patients with cervical cancer were studied, and among them, 63 patients (10.2%) underwent NACT. Eighteen patients (33.3%) did not require another treatment modality after chemotherapy and radical hysterectomy, while 66.7% (36 cases) of patients required chemoradiotherapy after NACT and radical hysterectomy, and recurrence was observed in 11.6% (5 cases) of patients. The 1-, 5- and 10-year PFS rate was 97.6% (95% CI: 84.2–99.6), 89.5% (95% CI: 74.4–95.9) and 89.5% (95% CI: 74.4–95.9), respectively. Conclusions: It can be concluded that a significant percentage of patients who are candidates for NACT followed by radical hysterectomy would require another modality of treatment, which is chemoradiotherapy; therefore, it is recommended that by conducting prospective studies, in addition to investigating this issue, the choice of the first method of patient treatment in these stages should be reconsidered so that patients do not suffer from two treatments and related complications, and undergo chemoradiotherapy from the beginning.http://www.sciencedirect.com/science/article/pii/S2666262025000130Chemo-radiotherapyNeoadjuvant chemotherapyRadical hysterectomyCervical cancerProgression-free survival |
| spellingShingle | Somayeh Nikfar Azam Sadat Mousavi Setareh Akhavan Shahrzad Sheikhhasani Amir Almasi-Hashiani Ramin Parvizrad Narges Zamani Chemo-radiotherapy after neoadjuvant chemotherapy and radical hysterectomy in women with stage IB-IIB cervical cancer: Do we need to change the therapeutic approach? A cohort study Surgery in Practice and Science Chemo-radiotherapy Neoadjuvant chemotherapy Radical hysterectomy Cervical cancer Progression-free survival |
| title | Chemo-radiotherapy after neoadjuvant chemotherapy and radical hysterectomy in women with stage IB-IIB cervical cancer: Do we need to change the therapeutic approach? A cohort study |
| title_full | Chemo-radiotherapy after neoadjuvant chemotherapy and radical hysterectomy in women with stage IB-IIB cervical cancer: Do we need to change the therapeutic approach? A cohort study |
| title_fullStr | Chemo-radiotherapy after neoadjuvant chemotherapy and radical hysterectomy in women with stage IB-IIB cervical cancer: Do we need to change the therapeutic approach? A cohort study |
| title_full_unstemmed | Chemo-radiotherapy after neoadjuvant chemotherapy and radical hysterectomy in women with stage IB-IIB cervical cancer: Do we need to change the therapeutic approach? A cohort study |
| title_short | Chemo-radiotherapy after neoadjuvant chemotherapy and radical hysterectomy in women with stage IB-IIB cervical cancer: Do we need to change the therapeutic approach? A cohort study |
| title_sort | chemo radiotherapy after neoadjuvant chemotherapy and radical hysterectomy in women with stage ib iib cervical cancer do we need to change the therapeutic approach a cohort study |
| topic | Chemo-radiotherapy Neoadjuvant chemotherapy Radical hysterectomy Cervical cancer Progression-free survival |
| url | http://www.sciencedirect.com/science/article/pii/S2666262025000130 |
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