The Effect of Neoadjuvant Chemotherapy on Lymph Node Metastasis of FIGO Stage IB1-IIB Cervical Cancer: A Systematic Review and Meta-Analysis.
The Effect of Neoadjuvant Chemotherapy on Lymph Node Metastasis of FIGO Stage IB1-IIB Cervical Cancer: A Systematic Review and Meta-Analysis.
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DOI：
10.3389/fonc.2020.570258
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发表时间：
2020
影响因子：
4.7
通讯作者：
Wang H
中科院分区：
文献类型：
--
作者：
Chen B;Wang L;Ren C;Shen H;Ding W;Zhu D;Mao L;Wang H
本研究旨在评估新辅助化疗（NACT）对FIGO IB 1-IIB期宫颈癌患者淋巴结转移（LNM）率的影响，并比较NACT联合手术与单纯手术的LNM。我们在PubMed、Web of Science、科克伦图书馆和EMBASE中确定了从成立到2019年7月27日的34项合格研究。由Stata（版本13）和Revman（版本5.3）进行数据分析。在这34项纳入研究中，合并的LNM发生率估计为23%（95% CI，0.20-0.26; I2 = 79.6%，P<0.001）。在亚组分析中，我们确定了五个因素，包括研究类型，发表年份，患者来自的大陆，组织学类型和FIGO分期。若考虑FIGO分期，IB期LNM发生率为13（95% CI：0.10-0.15; I2 = 5.5%，P=0.385），IIA期23%（95%CI：0.18-0.28; I2 = 0%，P=0.622），IIB期为27%（95%CI：0.20-0.33; I2 = 0%，P=0.898）。基于6项随机对照试验的NACT联合手术与单纯手术的比较，NACT联合手术患者淋巴结阳性发生率低于单纯手术患者（RR=0.57，95%CI：0.39-0.83; I2 = 60.5%，P=0.027）。NACT +手术组的5年OS高于单纯手术组（RR=1.13，95%CI：1.03-1.23; I2 = 0.0%，P=0.842）。在IB 1-IIB期宫颈癌中，术前NACT加根治性手术导致LNM的概率为23%，低于仅接受根治性手术的患者。在IIA和IIB期，NACT降低LNM的效果更明显。
This study aimed to assess the effect of neoadjuvant chemotherapy (NACT) on the rate of lymph node metastasis (LNM) in FIGO stage IB1-IIB cervical cancer patients and compare the LNM between NACT plus surgery and surgery only. We identified 34 eligible studies in PubMed, Web of Science, Cochrane Library, and EMBASE from inception to July 27, 2019. Data analyses were performed by Stata (version 13) and Revman (version 5.3). In these 34 included studies, the pooled incidence of LNM was estimated as 23% (95% CI, 0.20-0.26; I2 = 79.6%, P<0.001). In the subgroup analysis, we identified five factors, including study type, year of publication, continents from which patients came, histological type and the FIGO stage. When taking FIGO stage into consideration, the LNM rate was 13% in stage IB (95% CI: 0.10-0.15; I2 = 5.5%, P=0.385), 23% in stage IIA (95% CI: 0.18-0.28; I2 = 0%, P=0.622), and 27% in stage IIB (95% CI: 0.20-0.33; I2 = 0%, P=0.898), respectively. Through the comparison between NACT plus surgery and surgery only based on the six randomized controlled trials, the incidence of positive lymph nodes was lower in patients receiving NACT plus surgery than surgery only (RR=0.57, 95% CI: 0.39-0.83; I2 = 60.5%, P=0.027). The 5-year OS was higher in the NACT + surgery group than surgery-only group (RR=1.13, 95% CI: 1.03-1.23; I2 = 0.0%, P=0.842). Among cervical cancer in stage IB1-IIB, the preoperative NACT plus radical surgery resulted in a 23% probability of LNM, which was lower than those receiving radical surgery only. In stage IIA and IIB, the effect of NACT to reduce LNM was more obvious.
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影响因子：
2
作者：
Harbord, Roger M.;Egger, Matthias;Sterne, Jonathan A. C.
通讯作者：
Sterne, Jonathan A. C.
影响因子：
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通讯作者：
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