Abstract
Purpose
Recent studies have revealed that primary tumor resection (PTR) surgery could improve prognosis in some solid tumors. Thus, we aimed to investigate whether patients with stage IVB cervical carcinoma can benefit from PTR surgery and who can benefit.
Methods
We extracted and obtained data on patients with stage IVB cervical carcinoma from the SEER database from 2010 to 2017 and classified them into two groups: the surgery and the non-surgery group. The overall survival (OS) and cancer-specific survival (CSS) of the two groups were compared before and after propensity score matching (PSM). The independent prognostic variables were identified using univariate and multivariate Cox regression analyses. Then, the model was established to select the optimal patients to receive PTR surgery using multivariate logistic regression.
Results
After PSM, the study included 476 cervical carcinoma (stage IVB) patients, of whom 238 underwent PTR surgery. Compared to the non-surgery group, the surgery group’s median OS and median CSS were both longer (median OS: 27 months vs. 13 months, P < 0.001; median CSS: 52 months vs. 21 months, P < 0.001). The model showed no organ metastasis, adenocarcinoma, G1/2, and chemotherapy were more supportive of performing PTR surgery. The calibration curves and DCA showed that the model had high predictive accuracy and excellent clinical applicability. Finally, the “surgery benefit” group had the OS that was approximately four times better than “surgery non-benefit” group.
Conclusion
PTR surgery can potentially improve the prognosis of patients with cervical carcinoma at stage IVB. The model could probably select optimal candidates and provide a new perspective on individualized treatment.
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Data availability
The data were extracted from a public free database, SEER (https://seer.cancer.gov/).
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Acknowledgements
Thanks for the establishment and sharing of SEER database. We also thank to the patients who provided data to the SEER database.
Funding
The study was supported by Major Clinical Research Projects of the Second Affiliated Hospital, Air Force Medical University (2021LCYJ004).
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XHW, YQY and YNH designed the study. YSZ, YNH and SJH performed the experiments. YSZ and YNH analyzed the data. YNH, SJH, YSZ, ZXZ and BLZ wrote the manuscript. All the authors reviewed the final version of the article.
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He, Y., Zhang, Y., Hu, S. et al. Primary tumor resection improves survival benefit of stage IVB cervical carcinoma: a new perspective. J Cancer Res Clin Oncol 149, 11013–11023 (2023). https://doi.org/10.1007/s00432-023-04988-5
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DOI: https://doi.org/10.1007/s00432-023-04988-5