Oncological impact of pelvic vessels embolization in patients with locally advanced cervical cancer treated with concomitant chemoradiotherapy
This study aims to address the impact of pelvic vessel embolization on oncological outcomes in patients with locally advanced cervical cancer treated with concomitant chemoradiotherapy. This is a retrospective single-center cohort study including patients with locally advanced cervical cancer (International Federation of Gynecology and Obstetrics 2018 stages IB3-IVA), treated between January, 2010, and December, 2020. The primary outcome was overall survival, and the secondary outcome was disease-free survival. An inverse probability of treatment weighting was applied to balance baseline characteristics between groups and generate comparable cohorts. A total of 344 patients were included, of whom 8.4% (n = 29) underwent pelvic vessel embolization before the initiation of definitive treatment with concomitant chemoradiotherapy. In the embolized group, most (75.8%, n = 22) were classified as International Federation of Gynecology and Obstetrics 2018 stage III, and 44.8% of them (n = 13) had hemoglobin levels <10 g/dL before starting treatment. Overall survival rates were significantly worse in the embolized group in the analysis after inverse probability of treatment weighting (hazard ratio [HR] 2.60 [1.20-5.64], p < .05), however no statistically significant differences were observed in disease-free survival between embolized and non-embolized patients (HR 2.05 [0.91-4.59], p > .05). Patients with cervical cancer who underwent pelvic vessel embolization had worse overall survival in this cohort. Further studies are required to confirm this association.