Evidence map›Paper›PMID 31725793›Full record

SynthesisPloS one2019

Neoadjuvant chemotherapy plus surgery versus concurrent chemoradiotherapy in stage IB2-IIB cervical cancer: A systematic review and meta-analysis.

Wen Zou, Yiyu Han, Yang Zhang, Chunhong Hu, Yeqian Feng, Haixia Zhang, Jingjing Wang

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

14 citing papers in PubMed.

  1. Trial
  2. Article
  3. Article
  4. Review
  5. Article
  6. Article
  7. Observational
  8. The state of gynecologic radiation therapy in low- and middle-income countries.International journal of gynecological cancer : official journal of the International Gynecological Cancer Society · 2022
    Review
  9. Article
  10. Article
  11. Article
  12. Article
  13. Article
  14. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Wen ZouDepartment of Oncology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, People's Republic of China.
Yiyu HanDepartment of Oncology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, People's Republic of China.
Yang ZhangDepartment of Oncology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, People's Republic of China.
Chunhong HuDepartment of Oncology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, People's Republic of China.
Yeqian FengDepartment of Oncology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, People's Republic of China.
Haixia ZhangDepartment of Oncology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, People's Republic of China.
Jingjing WangDepartment of Oncology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, People's Republic of China.ORCID 0000-0002-6043-0964

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The optimal treatment strategy for stage IB2-IIB cervical cancer is controversial. This systematic review with meta-analysis evaluated the efficacy of concomitant chemoradiotherapy (CCRT) and neoadjuvant chemotherapy followed by radical surgery (NACT+S). Studies that evaluated NACT+S versus CCRT for patients with Federation of Gynecology and Obstetrics stage IB2-IIB cervical cancer were searched in MEDLINE, EMBASE, and the Cochrane Library database. Hazard ratios (HRs) with their respective 95% confidence intervals (CIs) were calculated using a random-effects model. Toxicity was also evaluated. Six qualified retrospective studies and one randomized controlled trial (2270 patients) were included in this review. The results suggested that compared with CCRT, NACT+S did not improve overall survival in all patients (HR 0.73, 95% CI 0.52-1.02) or stage IIB patients (HR 0.83, 95% CI 0.61-1.15). NACT+S did not improve disease-free survival (DFS) in stage IIB patients (HR 1.10, 95% CI 0.70-1.71). In the analysis of DFS in all patients, a high degree of heterogeneity was detected (I2 = 84%). Sensitivity analysis that eliminated these heterogeneous data suggested that CCRT could improve DFS over NACT+S (HR 1.47, 95% CI 1.12-1.93). Diarrhea and rectal and bladder complications occurred at a lower rate in the NACT+S group than in the CCRT group. NACT+S had no survival advantage for patients with stage IB2-IIB cervical cancer compared with CCRT but was associated with fewer side effects. Further prospective studies with a larger sample size of treatment protocols for locally advanced cervical cancer are needed.

Indexed as

AdultAgedAged, 80 and overChemoradiotherapyChemotherapy, AdjuvantFemaleHumansMiddle AgedNeoadjuvant TherapyNeoplasm StagingProportional Hazards ModelsUterine Cervical Neoplasms

Identifiers

PMID31725793
PMCPMC6855659

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.