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

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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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Acknowledgments

This paper is dedicated to my wife’s mother. Two months ago, she was diagnosed with stage IIB cervical cancer and was clinical responsible for cisplatin-based NAC. God Bless.

Conflict of interest

The authors had no conflict of interest to declare in relation to this article.

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Affiliated Hospital of Nantong University, Xi Si Road 20#, Nantong City, 226001, Jiangsu Province, People’s Republic of China

    Qing Ye

  2. Department of Interventional Radiology, Affiliated Hospital of Nantong University, Xi Si Road 20#, Nantong City, Jiangsu Province, People’s Republic of China

    Hong-Xin Yuan

  3. Nantong University, Qixiu Road 19#, Nantong City, Jiangsu Province, People’s Republic of China

    Hong-Lin Chen

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  1. Qing Ye
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  2. Hong-Xin Yuan
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Corresponding author

Correspondence to Qing Ye.

Appendix

Appendix

See Figs. 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, and 18.

Fig. 5
figure 5

Pooled OR of 2-year progression-free survival compared NAC responders with nonresponders

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Fig. 6
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The funnel plot of meta-analysis for 2-year progression-free survival compared NAC responders with nonresponders

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Fig. 7
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Pooled OR of 3-year progression-free survival compared NAC responders with nonresponders

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Fig. 8
figure 8

The funnel plot of meta-analysis for 3-year progression-free survival compared NAC responders with nonresponders

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Fig. 9
figure 9

Pooled OR of 5-year progression-free survival compared NAC responders with nonresponders

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Fig. 10
figure 10

The funnel plot of meta-analysis for 5-year progression-free survival compared NAC responders with nonresponders

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Fig. 11
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Pooled OR of 1-year overall survival compared NAC responders with nonresponders

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Fig. 12
figure 12

The funnel plot of meta-analysis for 1-year overall survival compared NAC responders with nonresponders

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Fig. 13
figure 13

Pooled OR of 2-year overall survival compared NAC responders with nonresponders

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Fig. 14
figure 14

The funnel plot of meta-analysis for 2-year overall survival compared NAC responders with nonresponders

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Fig. 15
figure 15

Pooled OR of 3-year overall survival compared NAC responders with nonresponders

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Fig. 16
figure 16

The funnel plot of meta-analysis for 3-year overall survival compared NAC responders with nonresponders

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Fig. 17
figure 17

Pooled OR of 5-year overall survival compared NAC responders with nonresponders

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Fig. 18
figure 18

The funnel plot of meta-analysis for 5-year overall survival compared NAC responders with nonresponders

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Ye, Q., Yuan, HX. & Chen, HL. Responsiveness of neoadjuvant chemotherapy before surgery predicts favorable prognosis for cervical cancer patients: a meta-analysis. J Cancer Res Clin Oncol 139, 1887–1898 (2013). https://doi.org/10.1007/s00432-013-1509-y

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  • DOI: https://doi.org/10.1007/s00432-013-1509-y

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