title: Pathologic response rate after concomitant neo-adjuvant radiotherapy and chemotherapy for adenocarcinoma of the uterine cervix: a retrospective multicentric study.
abstract: BACKGROUND
  Exclusive chemoradiotherapy (including brachytherapy) is the current standard of care for locoregionally advanced cervical cancer. The aim of the present study was to evaluate the responsiveness and to identify factors predicting the response to concomitant chemoradiotherapy before surgery in cervical adenocarcinoma.
  
  
  METHODS
  A multicentric retrospective study was done in 9 French centers. A total of 54 women with cervical adenocarcinoma stage IB2 to IIIB who had undergone concurrent chemoradiation therapy followed by surgical treatment were included. The patients were stratified by histopathologic response after concomitant chemoradiotherapy (lesions smaller than 1 cm or larger).
  
  
  RESULTS
  The median (SD) age at diagnosis was 44.2 (12.4) years (range, 19.3-77 years). The median (SD) follow-up duration was 30.9 (36.5) months (range, 4.1-17 years). After clinical evaluation, the mean (SD) tumor size was 5 (1.2) cm (range, 2-7 cm).The patients achieved a clinical complete response after concurrent chemoradiation in 18 cases (33.5%). Pathologic residual tumor was noted in 36 cases (67%); tumors smaller than 1 cm were found in 18 cases (33.5%), and lesions greater than 1 cm were observed in 18 cases (33.5%). Factors being associated with a significant decreased sensitivity to neoadjuvant chemoradiotherapy were the following: menopause (P = 0.012), parametrial invasion (P < 0.001), lymphovascular space invasion (P = 0.003), and mucinous subtype (P = 0.001).
  
  
  CONCLUSIONS
  Identification of predictive markers associated with incomplete response to neoadjuvant chemoradiotherapy in cervical adenocarcinoma may prove clinically useful and implement an individualized treatment plan.
authors.affiliation: Service de Gynécologie-Obstétrique, Hôpital Beaujon, Clichy, France. olivierpoujade@hotmail.com
authors.forename: Olivier
authors.initials: O
authors.lastname: Poujade
authors.forename: Philippe
authors.initials: P
authors.lastname: Morice
authors.forename: Roman
authors.initials: R
authors.lastname: Rouzier
authors.forename: Patrick
authors.initials: P
authors.lastname: Madelenat
authors.forename: Fabrice
authors.initials: F
authors.lastname: Lecuru
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Muray
authors.forename: Patrice
authors.initials: P
authors.lastname: Mathevet
authors.forename: Séverine
authors.initials: S
authors.lastname: Alran
authors.forename: Remy J
authors.initials: RJ
authors.lastname: Salmon
authors.forename: Fabien
authors.initials: F
authors.lastname: Reyal
mesh_terms: D000230:Adenocarcinoma / Q000628:therapy*; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000628:therapy*
chemical_list: D000970:Antineoplastic Agents