BACKGROUND The standard treatment for cervical cancer is chemoradiation although some patients showed treatment resistance. The purpose of this study was to investigate the clinical efficacy of surgery after chemoradiation for cervical cancer. METHODS Patients with FIGO stage IB2 to IIB cervical cancer were included in the study between 2005 and 2015. A total of 50 patients who underwent surgery after neoadjuvant chemoradiation and 76 patients who received only chemoradiation were compared. Baseline differences between the two groups were adjusted with inverse probability of treatment weighting method using propensity scores composed of the following independent variables: age, stage, tumor size, lymph node metastasis, and histological subtypes. RESULTS Median follow-up was 64.8 (range 4.8-143.9) months. After adjustment with inverse probability of treatment weighting, Kaplan-Meier curves showing adjusted progression-free survival and overall survival were significantly longer in the neoadjuvant chemoradiation compared with the chemoradiation-only group (p = 0.027 and p = 0.017, respectively). Moreover, in patients with squamous cell carcinoma, recurrence in previously irradiated field and recurrence both in and out of previously irradiated field were significantly decreased in the neoadjuvant chemoradiation compared with the chemoradiation-only group (3.1% and 18.4%, respectively; OR 0.142, p = 0.001]. Adverse events of surgery after chemoradiation were acceptable, although temporary hydronephrosis was frequently observed (23.1%). CONCLUSIONS Surgery after chemoradiation reduced pelvic recurrence, and as a result, patients who underwent neoadjuvant chemoradiation showed more favorable survival outcomes compared with those who only underwent chemoradiation.

中文翻译：

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同时放化疗后局部子宫切除术对局部晚期宫颈癌患者的作用。

背景技术尽管一些患者表现出治疗抵抗力，但是宫颈癌的标准治疗方法是化学放射疗法。这项研究的目的是调查化学放疗后宫颈癌手术的临床疗效。方法2005年至2015年间，将FIGO IB2至IIB期宫颈癌患者纳入研究。比较了新辅助放化疗后行手术的50例患者和仅接受化学放疗的76例患者。两组之间的基线差异通过使用倾向评分的逆加权治疗加权方法进行调整，倾向评分由以下独立变量组成：年龄，分期，肿瘤大小，淋巴结转移和组织学亚型。结果中位随访时间为64.8（范围4.8-143.9）个月。用治疗权重的反概率进行调整后，与仅进行化学放疗的组相比，在新辅助放化疗中，显示调整后的无进展生存期和总体生存期的Kaplan-Meier曲线明显更长（分别为p = 0.027和p = 0.017）。此外，与仅进行化学放疗的组相比，在鳞状细胞癌患者中，与仅进行化学放疗的组相比，新放化疗的患者在先前受照区域的复发和在先前受照区域内外的复发率均显着降低（分别为3.1％和18.4％；或0.142， p = 0.001]。尽管经常观察到暂时性肾积水（23.1％），但放化疗后的不良事件是可以接受的。结论放化疗后的手术减少了骨盆的复发，因此，