Meta-analysis Of The Efficacy Of Preoperative Neoadjuvant Chemotherapy On Locally Advanced Cervical Cancer And Clinical Study Of Prognosis

Objective: To evaluate the effect of neoadjuvant chemotherapy on the prognosis of patients with locally advanced cervical cancer and to explore the factors that influence the prognosis of patients.Methods: PubMed,EMBASE,Cochrane and other databases were searched,and relevant literatures were included.The extracted valid data were subjected to a meta-analysis of random or fixed effect models.According to the results of Meta analysis,the factors affecting the prognosis of patients were further explored.A retrospective analysis of 140 patients with locally advanced cervical cancer confirmed by pathology and receiving neoadjuvant chemotherapy before surgery.The cumulative disease-free survival of patients with different chemotherapy responses after neoadjuvant chemotherapy was compared.Multivariate Cox analysis affected the factors that influence the prognosis of patients.Results: 1.13 articles that met the inclusion criteria were retrieved.A meta-analysis of 13 articles showed that neoadjuvant chemotherapy was performed before surgery,and the 5-year overall survival(OR=1.24,95% CI 0.99-1.55)and disease-free survival(OR=1.23)compared with surgery alone.95% CI 0.80~1.88),parametrial infiltration rate(OR=0.62,95% CI 0.38~1.03),the difference was not statistically significant(P>0.05),however the difference of lymph node metastasis rate(OR=0.57,95%CI 0.40~0.79)was statistically significant(P < 0.05).2.After 2~3 cycles of neoadjuvant chemotherapy,77.86% of patients responded to neoadjuvant chemotherapy,22.14% did not respond to neoadjuvant chemotherapy,and the cumulative disease-free survival of the two groups was significantly different.Statistical significance(P <0.05).Multivariate Cox regression analysis of 8 indicators that may affect the prognosis of patients showed that patients with effective response to neoadjuvant chemotherapy may be an independent risk factor affecting the prognosis of patients.Conclusion: Preoperative neoadjuvant chemotherapy does not improve the patient’s short-term prognosis,and can reduce the risk of distant metastasis of carcinoma metastasis via lymph nodes.Patients with locally advanced cervical cancer respond to neoadjuvant chemotherapy may be an independent risk factor affecting the prognosis of patients.