Objective To evaluate the effects of age and the clinical response to neoadjuvant chemotherapy (NACT) in patients with cervical cancer who received neoadjuvant chemotherapy followed by radical surgery. Methods A total of 1,014 patients with advanced cervical cancer who received NACT followed by radical surgery were retrospectively selected. Patients were divided into young (aged <= 35 years, n = 177) and older (aged >35 years, n = 837) groups. We compared the short-term responses and survival rates between the groups. The five-year disease-free survival (DFS) and overall survival (OS) rates were stratified by age, NACT response, and FIGO stage. Results The overall response rate was 86.8% in the young group and 80.9% in the older group. The young patients had an earlier FIGO stage (P<0.001), a higher rate of adenocarcinoma (P = 0.022), and more lymph node metastasis (P = 0.033) than the older patients. The presence of adenocarcinoma as the histological type (P = 0.024) and positive lymph node metastasis (P<0.001) were identified as independent risk factors for survival. When stratified by age and clinical response, young patients with no response to NACT had a worse clinicopathological condition compared with the other subgroups. Compared with non-responders, responders to NACT had a higher five-year DFS rate (80.1% versus 71.8%; P = 0.019) and OS rate (82.6% versus 71.8%; P = 0.003) among the young patients but not among the older patients. Conclusions Responders to NACT aged 35 years or younger benefitted the most from NACT, while the young non-responders benefitted the least. Age might represent an important factor to consider when performing NACT in patients with cervical cancer.
基金:
Key Basic Research and Development Program Foundation of China (973 Program) [2015CB553903]; National Natural Science Foundation of China [91529102, 81572571, 81402160, 81302267, 81230038, 81230052, 30973472, 81001151, 81071663, 30973205, 30973184, 81090414, 81272422, 81172464, 81101964]
第一作者单位:[1]Huazhong Univ Sci & Technol, Tongji Med Coll, Tongji Hosp, Dept Obstet & Gynecol, Wuhan 430074, Peoples R China[2]Wuhan Univ, Ctr Canc, Renmin Hosp, Wuhan 430072, Hubei, Peoples R China
通讯作者:
推荐引用方式(GB/T 7714):
Zhou Jin,Li Xiong,Huang Kecheng,et al.Young Cervical Cancer Patients May Be More Responsive than Older Patients to Neoadjuvant Chemotherapy Followed by Radical Surgery[J].PLOS ONE.2016,11(2):doi:10.1371/journal.pone.0149534.
APA:
Zhou, Jin,Li, Xiong,Huang, Kecheng,Jia, Yao,Tang, Fangxu...&Li, Shuang.(2016).Young Cervical Cancer Patients May Be More Responsive than Older Patients to Neoadjuvant Chemotherapy Followed by Radical Surgery.PLOS ONE,11,(2)
MLA:
Zhou, Jin,et al."Young Cervical Cancer Patients May Be More Responsive than Older Patients to Neoadjuvant Chemotherapy Followed by Radical Surgery".PLOS ONE 11..2(2016)