Prognosis of locally advanced cervical cancer following neoadjuvant chemotherapy and radical surgery: A SEER database analysis

: Locally advanced cervical cancer presents significant challenges for treatment and prognosis. Neoadjuvant chemotherapy followed by radical surgery is a common approach for treating this condition. However, the influence of various factors on survival outcomes remains unclear. This study aims to analyze the prognosis of patients with locally advanced cervical cancer who received neoadjuvant chemotherapy combined with radical surgery using data from the SEER database. : A retrospective analysis was conducted on data from 3,850 cervical cancer patients in the SEER database. Univariate and multivariate Cox regression analyses were performed to identify factors affecting survival outcomes. A nomogram was used to visualize the impact of various prognostic factors on 1-year, 3-year, and 5-year survival probabilities. : The analysis showed significant differences in survival rates based on age, race, income, tumor grade, tumor size, treatment modality, staging, and other factors. Patients under 65 years of age, white patients, and those with higher incomes had higher survival rates. Advanced tumor stages (T3, T4) and tumor diameter greater than 6.6 cm were significantly associated with poorer survival rates. Compared to first-line treatment, neoadjuvant chemotherapy followed by radical surgery achieved relatively favorable survival outcomes. The nomogram effectively predicted survival probabilities with high accuracy in both training and validation groups. The AUC values for 1-year, 3-year, and 5-year survival rates were 0.84, 0.83, and 0.81 in the training group, and 0.78, 0.77, and 0.75 in the validation group, respectively. : This study, based on survival data analysis from the SEER database, elucidates that age, income, tumor diameter, treatment modality, differentiation grade, tumor staging, and pathological type are closely related to the prognosis of LACC patients. NACT combined with radical surgery can improve survival outcomes in LACC patients and, under certain conditions, is not inferior to chemoradiotherapy. The analysis of the impact of different individual conditions on LACC survival outcomes provides reference and assistance for medical decision-making in LACC.