Evidence map›Paper›PMID 33575846›Full record

ArticleArchives of gynecology and obstetrics2021

Is there a benefit for adjuvant radio(chemo)therapy in early cervical cancer? Results from a population-based study.

Sophia Scharl, Cornelia Becher, Michael Gerken, Anton Scharl, Michael Anapolski, Atanas Ignatov, Elisabeth C Inwald, Olaf Ortmann, Oliver Kölbl, Monika Klinkhammer-Schalke and 1 more

Registry-linked trialAbstract read
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In one paragraph

Article in Archives of gynecology and obstetrics, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04989647 (An International Randomised Trial of Radical Surgery Followed by Adjuvant), which is not on this map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.3field-weighted citation impact, top 20% of its field
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.

NCT04989647 phase3recruitingnot on this mapstarted 2022, after this paper: background citation

An International Randomised Trial of Radical Surgery Followed by Adjuvant (Chemo)Radiation Versus no Further Treatment in Patients With Early-stage, Intermediate-risk Cervical Cancer Patients

TypeinterventionalSponsorThe Central and Eastern European Gynecologic Oncology GroupRan2022 to 2032Enrolled514ConditionsCervical CancerArmsNo adjuvant therapy, Adjuvant radiotherapy
3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 11 citations in OpenAlex.

  1. Review
  2. Article
  3. Article
  4. [Routine Practice Data for Health Care Analyses: Part 3 of the Manual].Gesundheitswesen (Bundesverband der Arzte des Offentlichen Gesundheitsdienstes (Germany)) · 2023
    Article
  5. Article
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

11 authors at 5 institutions in 1 country.

Sophia ScharlDepartment of Radiation Oncology and Nuclear Medicine, Medizinisches Versorgungszentrum am Klinikum Rosenheim, Rosenheim, Germany. sophiascharl@yahoo.de.ORCID 0000-0001-6849-6880
Cornelia BecherTumor Center, Institute for Quality Assurance and Health Services Research, University of Regensburg, Regensburg, Germany.
Michael GerkenTumor Center, Institute for Quality Assurance and Health Services Research, University of Regensburg, Regensburg, Germany.
Anton ScharlDepartment of Gynecology and Obstetrics, Klinikum St. Marien Amberg, Amberg, Germany.
Michael AnapolskiDepartment Ob/Gyn, University of Witten-Herdecke, KKH Dormagen, Dormagen, Germany.
Atanas IgnatovDepartment of Gynecology and Obstetrics, University Medical Center Regensburg, Regensburg, Germany.
Elisabeth C InwaldDepartment of Gynecology and Obstetrics, University Medical Center Regensburg, Regensburg, Germany.
Olaf OrtmannDepartment of Gynecology and Obstetrics, University Medical Center Regensburg, Regensburg, Germany.
Oliver KölblDepartment of Radiation Oncology, University Medical Center Regensburg, Regensburg, Germany.
Monika Klinkhammer-SchalkeTumor Center, Institute for Quality Assurance and Health Services Research, University of Regensburg, Regensburg, Germany.
Thomas PapathemelisDepartment of Gynecology and Obstetrics, Klinikum St. Marien Amberg, Amberg, Germany.
University Hospital Regensburg · DEUniversity of Regensburg · DEKlinikum St. Marien Amberg · DEKreiskrankenhaus Dormagen · DERoMed Kliniken · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeDue to insufficient and conflicting prospective evidence, the recommendations on when to apply adjuvant radiochemotherapy in early-stage cervical cancer vary between international guidelines. In this population-based study, we evaluated the outcome of patients with early-stage cervical cancer based on risk factors and the adjuvant therapy they received.

methodsThe effect of primary therapy (surgery and radiochemotherapy RCT, surgery and radiotherapy RT, and surgery alone) on overall survival (OS) and recurrence-free survival (RFS) was evaluated in the complete cohort of 442 patients and in subgroups according to risk profile and nodal status.

resultsIn low-risk patients, there was no difference in OS (p = 0.276) depending on whether patients received adjuvant therapy or not. Concerning RFS, patients with RT (including one patient with RCT) exhibited a significantly worse outcome compared to the group with surgery alone (p = 0.015). In intermediate-risk patients, the administration of adjuvant RT significantly benefited RFS when compared to surgery only in multivariate analysis (p = 0.031). Concerning OS, no significant influence for adjuvant treatment could be seen (p = 0.354). Though trends towards better OS and RFS could be observed in patients of the high-risk group-both in RCT and RT groups compared to surgery alone-the effects did not prove to be significant.

conclusionOur study reaffirms the evidence against the use of adjuvant radio(chemo)therapy in low-risk early-stage cervical cancer. In intermediate-, and less pronounced in high-risk patients, however, it seems to be beneficial. The role of adjuvant radio(chemo)therapy in early cervical cancer should be further investigated in prospective randomized trials.

Indexed as

AdultAgedAged, 80 and overAntineoplastic AgentsChemotherapy, AdjuvantCombined Modality TherapyFemaleHumansKaplan-Meier EstimateMiddle AgedNeoplasm StagingRadiotherapy, AdjuvantRadiotherapy DosageSurvival RateTreatment OutcomeUterine Cervical NeoplasmsAntineoplastic AgentsAdjuvant therapyCervical cancerRadio(chemo)therapyRisk groups

Identifiers

PMID33575846
OpenAlexW3126451571

What OpenQuestion holds

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Registered trials

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.