title: Survival benefits of neoadjuvant chemotherapy followed by radical surgery versus radiotherapy in locally advanced chemoresistant cervical cancer.
abstract: The aim of this study was to analyze long-term survivals in patients with stage IB to IIA cervical cancer treated by neoadjuvant chemotherapy setting. Between February 1989 and January 1998, 94 women with previously untreated stage IB to IIA carcinoma of the uterine cervix who received cisplatin based neoadjuvant chemotherapy were enrolled in this study. All of patients with chemoresponse (complete response, n=15; partial response, n=47) and 16 patients with chemoresistance received radical surgery (RS group). The other 16 patients with chemoresistance received radiotherapy for definite treatment (RT group). In the RS group, the 10 yr survival estimation in patients with bulky tumors (diameter > or =4 cm, n=26) was similar to that with non-bulky tumors (83.3% vs. 89.3%, p=NS). In selected patients with chemoresistance, those treated by radiotherapy (n=16) showed significantly poorer survivals than those treated by radical surgery (n=16) (10 yr survival rates of RT (25%) vs. RS (76.4%), p=0.0111). Our results support that a possible therapeutic benefit of neoadjuvant chemotherapy plus radical surgery is only in patients with bulky stage IB to IIA cervical cancer. In cases of chemoresistance, radical surgery might be a better definite treatment option.
authors.affiliation: Department of Obstetrics and Gynecology, Catholic University of Daegu, Nam-gu, Daegu, Korea. drcys@cu.ac.kr
authors.forename: Youn Seok
authors.initials: YS
authors.lastname: Choi
authors.forename: Jeong-Im
authors.initials: JI
authors.lastname: Sin
authors.forename: Ju Hyun
authors.initials: JH
authors.lastname: Kim
authors.forename: Gi Won
authors.initials: GW
authors.lastname: Ye
authors.forename: Im Hee
authors.initials: IH
authors.lastname: Shin
authors.forename: Tae Sung
authors.initials: TS
authors.lastname: Lee
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D019008:Drug Resistance, Neoplasm; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy / Q000532:radiotherapy* / Q000601:surgery*
chemical_list: D002945:Cisplatin; D005472:Fluorouracil