Impact of histological subtype on the response to chemoradiation in locally advanced cervical cancer and the possible role of surgery

Voinea,Silviu; Herghelegiu,Cătălin Gabriel; Sandru,Angela; Ioan,Raluca   Gabriela; Bohilțea,Roxana Elena; Bacalbașa,Nicolae; Chivu,Laura Ioana; Furtunescu,Florentina; Stanica,Diana Catalina; Neacșu,Adrian

doi:10.3892/etm.2020.9525

Impact of histological subtype on the response to chemoradiation in locally advanced cervical cancer and the possible role of surgery

Authors:
- Silviu Voinea
- Cătălin Gabriel Herghelegiu
- Angela Sandru
- Raluca Gabriela Ioan
- Roxana Elena Bohilțea
- Nicolae Bacalbașa
- Laura Ioana Chivu
- Florentina Furtunescu
- Diana Catalina Stanica
- Adrian Neacșu
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Affiliations: Department of Surgery, Oncology Institute ‘Prof. Dr. Alexandru Trestioreanu’, ‘Carol Davila’ University of Medicine and Pharmacy, 050474 Bucharest, Romania, Department of Obstetrics and Gynecology, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania, Department of Pathophysiology, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania, Department of Public Health and Management, Faculty of Medicine, ‘Carol Davila’ University of Medicine and Pharmacy, 050463 Bucharest, Romania, Department of Obstetrics and Gynecology, ‘Sfantul Ioan’ Emergency Clinical Hospital, 042122 Bucharest, Romania
Published online on: November 26, 2020 https://doi.org/10.3892/etm.2020.9525
Article Number: 93

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Abstract

Cervical cancer is one of the most common cancers in women in developing countries, second only to breast cancer, with more than 450.000 new cases every year. Romania has the highest incidence of cervical cancer in Europe; more than four times the incidence found in Western Europe. Radiotherapy with or without chemotherapy is considered in most countries the gold standard for locally advanced cervical cancer. In Romania, if downstaging occurs after radiotherapy, adjuvant surgery is routinely performed. Thus, in the present study, we investigated the rate of residual cancer in patients with locally advanced cervical cancer who underwent surgery after concurrent chemoradiotherapy and to determine the impact of tumor histological subtype on the chemoradiotherapy response. Of a total of 461 patients with locally advanced cervical cancer that underwent chemoradiotherapy and adjuvant surgery, 254 had a partial response defined as the presence of residual tumor at pathology examination. Depending on the histological subtype of the cervical cancer, partial response was obtained in 50.6% of squamous cell carcinoma cases and in 77.6% of adenocarcinoma or adenosquamous carcinoma cases. The present study demonstrated that cervical cancer patients with adenocarcinomas and adenosquamous carcinomas had a significantly poorer treatment response to chemoradiotherapy than those with squamous cell carcinomas. We consider that in such cases where residual tumor is present, adjuvant surgery is mandatory for improving the survival rates.

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