Cochrane · systematic review · CD010260

Hysterectomy with radiotherapy or chemotherapy or both for women with locally advanced cervical cancer

Kokka, F, Bryant, A, Olaitan, A, et al. · Cochrane Database of Systematic Reviews · 2022 · Cochrane Library

Gynaecological, Neuro-oncology and Orphan Cancer2 versionsAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
21
current version
GRADE rated
15
No studies
6
Included studies
NR
No studies 6 · 28.6%Ungraded 0 · 0%Very low 4 · 19%Low 8 · 38.1%Moderate 3 · 14.3%High 0 · 0%

Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.

Questions and results

Show all 2 versions

Hysterectomy (radical) with neoadjuvant chemotherapy versus chemoradiotherapy alone for women with locally advanced cervical cancer

Population: women with locally advanced cervical cancer
4 questions
OutcomeEffectEvidenceStatus / GRADE
Overall survival Median
Hysterectomy (radical) with neoadjuvant chemotherapy vs chemoradiotherapy alone
HR 0.94 [0.76, 1.16]2 studies · 1253 participantsModerate
Downgraded: risk of bias, imprecision
DFS Median
Hysterectomy (radical) with neoadjuvant chemotherapy vs chemoradiotherapy alone
HR 1.38 [1.02, 1.87]1 study · 633 participantsLow
Downgraded: risk of bias, imprecision
Quality of life
Hysterectomy (radical) with neoadjuvant chemotherapy vs chemoradiotherapy alone
no estimate extractedNRNo studies
SAEs and toxicity
Hysterectomy (radical) with neoadjuvant chemotherapy vs chemoradiotherapy alone
OR 41 study · 198 participantsVery low
Downgraded: risk of bias

Hysterectomy (simple or radical) with neoadjuvant chemotherapy versus radiotherapy alone for women with locally advanced cervical cancer

Population: women with locally advanced cervical cancer
4 questions
OutcomeEffectEvidenceStatus / GRADE
Overall survival Median
Hysterectomy (simple or radical) with neoadjuvant chemotherapy vs radiotherapy alone
HR 0.71 [0.55, 0.93]3 studies · 571 participantsModerate
Downgraded: risk of bias
Disease‐ or progression‐free survival Median
Hysterectomy (simple or radical) with neoadjuvant chemotherapy vs radiotherapy alone
HR 0.75 [0.53, 1.05]3 studies · 571 participantsModerate
Downgraded: risk of bias
Quality of life
Hysterectomy (simple or radical) with neoadjuvant chemotherapy vs radiotherapy alone
no estimate extractedNRNo studies
Severe adverse events and toxicity
Hysterectomy (simple or radical) with neoadjuvant chemotherapy vs radiotherapy alone
RR 1.32 [0.47, 3.71]1 study · 118 participantsLow

Hysterectomy (simple or radical) with radiotherapy versus radiotherapy alone

Population: women with locally advanced cervical cancer
5 questions
OutcomeEffectEvidenceStatus / GRADE
Overall survival Median
Hysterectomy (simple or radical) with radiotherapy vs radiotherapy alone
HR 0.89 [0.61, 1.29]1 study · 256 participantsLow
Downgraded: imprecision
Progression‐free survival Median
Hysterectomy (simple or radical) with radiotherapy vs radiotherapy alone
HR 0.77 [0.54, 1.1]1 study · 256 participantsLow
Downgraded: imprecision
Tumour‐free actuarial survival at 5 years
Hysterectomy (simple or radical) with radiotherapy vs radiotherapy alone
no estimate extracted1 study · 118 participantsVery low
Downgraded: imprecision
Quality of life
Hysterectomy (simple or radical) with radiotherapy vs radiotherapy alone
no estimate extractedNRNo studies
Severe/serious adverse events
Hysterectomy (simple or radical) with radiotherapy vs radiotherapy alone
OR 42 studies · 374 participantsLow
Downgraded: imprecision

Hysterectomy (simple or radical) with chemoradiotherapy versus chemoradiotherapy alone

Population: women with locally advanced cervical cancer
4 questions
OutcomeEffectEvidenceStatus / GRADE
Overall survival Median
Hysterectomy (simple or radical) with chemoradiotherapy vs chemoradiotherapy alone
no estimate extracted1 study · 102 participantsVery low
Downgraded: imprecision
Progression or event‐free survival Median
Hysterectomy (simple or radical) with chemoradiotherapy vs chemoradiotherapy alone
no estimate extracted2 studies · 163 participantsVery low
Downgraded: imprecision
Quality of life
Hysterectomy (simple or radical) with chemoradiotherapy vs chemoradiotherapy alone
no estimate extractedNRNo studies
Severe/serious adverse events
Hysterectomy (simple or radical) with chemoradiotherapy vs chemoradiotherapy alone
no estimate extractedNRNo studies

Hysterectomy (simple or radical) with chemoradiotherapy versus internal radiotherapy (brachytherapy) with chemoradiotherapy

Population: women with locally advanced cervical cancer
4 questions
OutcomeEffectEvidenceStatus / GRADE
Overall survival Median
Hysterectomy (simple or radical) with chemoradiotherapy vs internal radiotherapy (brachytherapy) with chemoradiotherapy
HR 0.65 [0.35, 1.21]1 study · 211 participantsLow
Downgraded: imprecision
Progression or event‐free survival Median
Hysterectomy (simple or radical) with chemoradiotherapy vs internal radiotherapy (brachytherapy) with chemoradiotherapy
HR 0.7 [0.31, 1.34]1 study · 211 participantsLow
Downgraded: imprecision
Quality of life
Hysterectomy (simple or radical) with chemoradiotherapy vs internal radiotherapy (brachytherapy) with chemoradiotherapy
no estimate extractedNRNo studies
Severe late complications
Hysterectomy (simple or radical) with chemoradiotherapy vs internal radiotherapy (brachytherapy) with chemoradiotherapy
OR 41 study · 211 participantsLow
Downgraded: imprecision