Treatment of stage IB2, IIA bulky cervical cancer: a single-institution experience of neoadjuvant chemotherapy followed by radical hysterectomy and primary radical hysterectomy.
BACKGROUND
The aim of this study was to compare the efficacy and safety of neoadjuvant chemotherapy (NAC) followed by radical hysterectomy (NAC group) with primary radical hysterectomy (RH group).


METHODS
We reviewed all patients with bulky stage IB-IIA cervical cancer treated at Seoul National University Hospital from January 1, 2000 to December 31, 2006. Thirty-three patients were treated with NAC prior to radical hysterectomy, and 41 patients were treated with radical hysterectomy.


RESULTS
Clinical characteristics were not significantly different between the two groups. The response rate in the NAC group was 81.8%. Operation time, estimated blood loss, and complication rate were not significantly different between the two groups. Pathologic outcomes were improved in the NAC group. Adjuvant therapy was less frequently performed in the NAC group (51.6%) than in the RH group (82.9%) (P = 0.005). The 5-year progression-free survival was 90.7% in the NAC group and 81.3% in the RH group, but the difference was not statistically significant (P = 0.297).


CONCLUSIONS
The results of this study suggest that NAC may improve pathologic outcomes, decrease the need for adjuvant radiation therapy and have a comparable operation feasibility without affecting progression-free survival.
Lee
Jung-Yun
JY
Department of Obstetrics and Gynecology, Seoul National University College of Medicine, 28 Yongun-dong, Jongno-gu, 110-744 Seoul, Korea.
Kim
Yun Hwan
YH
Kim
Min-Jeong
MJ
Kim
Kidong
K
Chung
Hyun Hoon
HH
Park
Noh-Hyun
NH
Song
Yong-Sang
YS
Kang
Soon-Beom
SB
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D001918:Brachytherapy; D016190:Carboplatin / Q000008:administration & dosage; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D018572:Disease-Free Survival; D019583:Dose Fractionation, Radiation; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D007044:Hysterectomy; D053208:Kaplan-Meier Estimate; D008207:Lymphatic Metastasis; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000009:adverse effects; D009361:Neoplasm Invasiveness; D017239:Paclitaxel / Q000008:administration & dosage; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D016896:Treatment Outcome; D047368:Tumor Burden / Q000187:drug effects; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000628:therapy*
D016190:Carboplatin; D017239:Paclitaxel; D002945:Cisplatin; D005472:Fluorouracil