Stübs FA, Koch M, Beckmann M (2019)
Publication Type: Journal article, Review article
Publication year: 2019
DOI: 10.1007/s00129-019-4441-7
Background: The neoadjuvant treatment concept is nowadays the standard of care for many different organ entities. The neoadjuvant treatment also seems to be of interest in special situations for cervical cancer. Objective: This article gives an overview of the currently discussed fields of application of neoadjuvant therapy in treating patients with cervical cancer and the various options are discussed. Material and methods: This article is based on the national S3 guidelines for diagnostics, treatment and follow-up of patients with cervical cancer of the Association of the Scientific Medical Societies of Germany (AWMF, register number 032/033OL in the version from 2014). Additionally, this was extended by the literature for the update research of the new version of the guidelines. Results: The response rate to neoadjuvant therapy is 84%. The 5‑year progression-free survival and overall survival are 61.9% and 72.8%, respectively. Women responding to neoadjuvant therapy have a better long-term survival than non-responders. In a Cochrane meta-analysis from 2012 neoadjuvant chemotherapy before the planned operation improved the progression-free survival (hazard ratio, HR 0.75, 95% confidence interval, CI 0.61–0.93, P = 0.008) and the overall survival (HR 0.77, 95% CI 0.62–0.96, P = 0.02). The results were no longer significant when the random effects model was used (odds ratio, OR 0.60, 95% CI 0.32–1.12, P = 0.11). In macroinvasive cervical cancer during pregnancy neoadjuvant therapy is an established component of treatment. Discussion: The data on the use of neoadjuvant therapy in treating cervical cancer is unclear. The neoadjuvant therapy is currently not a standard of care in the treatment of cervical cancer. The roles of operative staging and positive lymph nodes after neoadjuvant therapy are also unresolved. Various meta-analyses could show that neoadjuvant therapy improves progression-free and overall survival. This is especially true for women who respond to this treatment.
APA:
Stübs, F.A., Koch, M., & Beckmann, M. (2019). Neoadjuvante Therapiekonzepte beim Zervixkarzinom. Gynäkologe. https://doi.org/10.1007/s00129-019-4441-7
MLA:
Stübs, Frederik A., Martin Koch, and Matthias Beckmann. "Neoadjuvante Therapiekonzepte beim Zervixkarzinom." Gynäkologe (2019).
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