Clinical Research Papers:
Early response to neoadjuvant chemotherapy can help predict long-term survival in patients with cervical cancer
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Xiong Li1,2,*, Kecheng Huang1,*, Qinghua Zhang1,2,*, Jian Shen2, Hang Zhou3, Runfeng Yang4, Lin Wang1, Jiong Liu5, Jincheng Zhang6, Haiying Sun1, Yao Jia1, Xiaofang Du1,2, Haoran Wang7, Song Deng8, Ting Ding1, Jingjing Jiang1, Yunping Lu1, Shuang Li1, Shixuan Wang1 and Ding Ma1
1 Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
2 Department of Obstetrics and Gynecology, Wuhan Central Hospital, Wuhan, Hubei, China
3 Department of Obstetrics and Gynecology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, China
4 Hubei Tumor Hospital, Wuhan, Hubei, China
5 Shanghai Jiao Tong University School of Medicine, Shanghai, China
6 Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
7 Department of Internal Medicine, Luohe Renmin Hospital, The First Affiliated Hospital of Luohe Medical College, Luohe, Henan, China
8 Department of Obstetrics and Gynecology, University Hospital of Hubei University for Nationalities, Enshi, Hubei, China
* These authors have contributed equally to this work
Shuang Li, email:
Shixuan Wang, email:
Ding Ma, email:
Keywords: cervical cancer, clinical response, neoadjuvant chemotherapy (NACT), predictor, disease-free survival (DFS)
Received: April 11, 2016 Accepted: August 13, 2016 Published: August 20, 2016
It is still controversial whether cervical cancer patients with clinical responses after neoadjuvant chemotherapy (NACT) have a better long-term survival or not. This study was designed to investigate the effect of the clinical response on the disease-free survival (DFS) of cervical cancer patients undergoing NACT. A total of 853 patients from a retrospective study were used to evaluate whether the clinical response was an indicator for the long-term response, and 493 patients from a prospective cohort study were used for further evaluation. The survival difference was detected by log-rank test, univariate and multivariate Cox regression and a pooled analysis. The log-rank test revealed that compared with non-responders, the DFS of responders was significantly higher in the retrospective data (P = 0.007). Univariate Cox regression showed that the clinical response was an indicator of long-term survival in the retrospective study (HR 1.83, 95% CI 1.18-2.85, P = 0.007). In a multivariate Cox model, the clinical response was still retained as an independent significant prognostic factor in the retrospective study (HR 1.59, 95% CI 1.01-2.50, P = 0.046). The result was also validated in the prospective data with similar results. These findings implied that the clinical response can be regarded as an independent predictor of DFS.
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