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
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
Current version onlyHysterectomy (radical) with neoadjuvant chemotherapy versus chemoradiotherapy alone for women with locally advanced cervical cancer
Population: women with locally advanced cervical cancer
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Overall survival Median Hysterectomy (radical) with neoadjuvant chemotherapy vs chemoradiotherapy alone | HR 0.94 [0.76, 1.16] | 2 studies · 1253 participants | Moderate 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 participants | Low Downgraded: risk of bias, imprecision |
Quality of life Hysterectomy (radical) with neoadjuvant chemotherapy vs chemoradiotherapy alone | no estimate extracted | NR | No studies |
SAEs and toxicity Hysterectomy (radical) with neoadjuvant chemotherapy vs chemoradiotherapy alone | OR 4 | 1 study · 198 participants | Very 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
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Overall survival Median Hysterectomy (simple or radical) with neoadjuvant chemotherapy vs radiotherapy alone | HR 0.71 [0.55, 0.93] | 3 studies · 571 participants | Moderate 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 participants | Moderate Downgraded: risk of bias |
Quality of life Hysterectomy (simple or radical) with neoadjuvant chemotherapy vs radiotherapy alone | no estimate extracted | NR | No 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 participants | Low |
Hysterectomy (simple or radical) with radiotherapy versus radiotherapy alone
Population: women with locally advanced cervical cancer
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Overall survival Median Hysterectomy (simple or radical) with radiotherapy vs radiotherapy alone | HR 0.89 [0.61, 1.29] | 1 study · 256 participants | Low 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 participants | Low Downgraded: imprecision |
Tumour‐free actuarial survival at 5 years Hysterectomy (simple or radical) with radiotherapy vs radiotherapy alone | no estimate extracted | 1 study · 118 participants | Very low Downgraded: imprecision |
Quality of life Hysterectomy (simple or radical) with radiotherapy vs radiotherapy alone | no estimate extracted | NR | No studies |
Severe/serious adverse events Hysterectomy (simple or radical) with radiotherapy vs radiotherapy alone | OR 4 | 2 studies · 374 participants | Low Downgraded: imprecision |
Hysterectomy (simple or radical) with chemoradiotherapy versus chemoradiotherapy alone
Population: women with locally advanced cervical cancer
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Overall survival Median Hysterectomy (simple or radical) with chemoradiotherapy vs chemoradiotherapy alone | no estimate extracted | 1 study · 102 participants | Very low Downgraded: imprecision |
Progression or event‐free survival Median Hysterectomy (simple or radical) with chemoradiotherapy vs chemoradiotherapy alone | no estimate extracted | 2 studies · 163 participants | Very low Downgraded: imprecision |
Quality of life Hysterectomy (simple or radical) with chemoradiotherapy vs chemoradiotherapy alone | no estimate extracted | NR | No studies |
Severe/serious adverse events Hysterectomy (simple or radical) with chemoradiotherapy vs chemoradiotherapy alone | no estimate extracted | NR | No studies |
Hysterectomy (simple or radical) with chemoradiotherapy versus internal radiotherapy (brachytherapy) with chemoradiotherapy
Population: women with locally advanced cervical cancer
| Outcome | Effect | Evidence | Status / 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 participants | Low 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 participants | Low Downgraded: imprecision |
Quality of life Hysterectomy (simple or radical) with chemoradiotherapy vs internal radiotherapy (brachytherapy) with chemoradiotherapy | no estimate extracted | NR | No studies |
Severe late complications Hysterectomy (simple or radical) with chemoradiotherapy vs internal radiotherapy (brachytherapy) with chemoradiotherapy | OR 4 | 1 study · 211 participants | Low Downgraded: imprecision |
Comparison
Population: Women with locally advanced cervical cancer
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Overall survival Median | HR 0.71 [0.55, 0.93] | 3 studies · 571 participants | Moderate |
Disease or progression‐free survival Median | HR 0.75 [0.53, 1.05] | 3 studies · 571 participants | Moderate |
Severe adverse events and toxicity | RR 1.32 [0.47, 3.71] | 1 study · 118 participants | Low |