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Published in: Journal of Cancer Research and Clinical Oncology 11/2013

01-11-2013 | Original Paper

Responsiveness of neoadjuvant chemotherapy before surgery predicts favorable prognosis for cervical cancer patients: a meta-analysis

Authors: Qing Ye, Hong-Xin Yuan, Hong-Lin Chen

Published in: Journal of Cancer Research and Clinical Oncology | Issue 11/2013

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Abstract

Background

Neoadjuvant chemotherapy (NAC) before surgery has already shown the therapy effectiveness in patients with cervical cancer. The present meta-analysis was conducted to determine whether the response to NAC predicts for prognosis.

Methods

Systematic computerized searches of the PubMed and Web of Knowledge were performed. Prognosis outcomes included progression-free survival (PFS), and overall survival (OS). The pooled odd ratio (OR) was estimated by using fixed-effect model or random-effect model according to heterogeneity between studies.

Results

Eighteen studies with 1,785 patients were included. Cisplatin-based NAC treatments were most commonly used. The clinical response rate ranged from 48.4 to 93.0 %, and the pathological response rate ranged from 27.6 to 30.6 %. The pooled ORs estimating the association of PFS with NAC response were 5.707 (95 % CI 3.564–9.137), 6.798 (95 % CI 4.716–9.799), 6.327 (95 % CI 4.398–9.102), and 5.214 (95 % CI 3.748–7.253) at 1-, 2-, 3-, and 5-year follow-up, respectively, and the pooled ORs estimating the association of OS with NAC response were 6.179 (95 % CI 3.390–11.264), 9.155 (95 % CI 5.759–14.555), 8.431 (95 % CI 5.667–12.543), and 5.785 (95 % CI 4.124–8.115) at 1-, 2-, 3-, and 5-year follow-up, respectively. No obvious statistical heterogeneity was detected. Funnel plots and Egger’s tests did not reveal publication bias. Sensitivity analysis showed the results of meta-analysis were robust.

Conclusion

This meta-analysis confirms that response to NAC is an indicator for PFS and OS, and suggests that patients-achieving response of NAC before surgery predicts favorable prognosis for cervical cancer patients.
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Metadata
Title
Responsiveness of neoadjuvant chemotherapy before surgery predicts favorable prognosis for cervical cancer patients: a meta-analysis
Authors
Qing Ye
Hong-Xin Yuan
Hong-Lin Chen
Publication date
01-11-2013
Publisher
Springer Berlin Heidelberg
Published in
Journal of Cancer Research and Clinical Oncology / Issue 11/2013
Print ISSN: 0171-5216
Electronic ISSN: 1432-1335
DOI
https://doi.org/10.1007/s00432-013-1509-y

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