2020 Volume 2 Issue 3 Pages 75-83
BACKGROUND
Unlike the recommendations made in many other countries, Japanese guidelines equally recommend radical hysterectomy or concurrent chemoradiotherapy for treatment of stage IIB cervical carcinoma. The main study objective was to compare the overall mortality of hysterectomy versus concurrent chemoradiotherapy as primary treatment in patients with localized or regionally extended cervical cancer.
METHODS
Using Diagnosis Procedure Combination database combined with population-based cancer registry data in Osaka Prefecture, Japan, we conducted a retrospective cohort study. All adult patients who had been diagnosed with cervical cancer, registered in the population-based cancer registry from January 1, 2010 to December 31, 2015 were included. To compare overall mortality between patients who received radical hysterectomy and concurrent chemoradiotherapy as primary treatment, we performed a Cox regression analysis of the original cohort, and Kaplan-Meier analysis with stabilized inverse probability of treatment weights using propensity score.
RESULTS
Among 740 eligible patients, 564 patients were included in the hysterectomy group and 176 patients were included in the concurrent chemoradiotherapy group. Primary hysterectomy was not independently associated with overall mortality (adjusted HR 0.70, 95% CI 0.46–1.07) by the Cox regression analysis. The Kaplan-Meier analysis with stabilized inverse probability of treatment weights did not show a significant difference in overall mortality between the two groups (P = 0.096).
CONCLUSIONS
This study indicates that primary treatment type (hysterectomy versus concurrent chemoradiotherapy) was not statistically associated with overall mortality among patients diagnosed with localized or regionally extended cervical cancer.
