title: Clinical evaluation of neoadjuvant chemotherapy followed by radical surgery in the management of stage IB2-IIB cervical cancer.
abstract: OBJECTIVE
  To evaluate clinical efficacy, toxicity, and survival outcomes of neoadjuvant chemotherapy (NACT) followed by radical surgery (RS) among patients with cervical cancer stage IB2-IIB.
  
  
  METHODS
  In a retrospective clinical study at West China Second Hospital, Chengdu, data were analyzed from 414 patients who underwent NACT followed by radical surgery (NACT-RS) or RS alone between January 2008 and November 2009.
  
  
  RESULTS
  The clinical response for NACT was 90%. Lymph node metastasis (25% versus 48%, P<0.05) and deep cervical stromal invasion more than 0.5, (68% versus 91%, P<0.05) were significantly lower among responders than among non-responders, respectively, in the NACT-RS group. The 2-year progression-free survival and 2-year overall survival were 93.0% and 95.5% in the NACT-RS group, and 94.5% and 97.1% in the RS group (P>0.05). Parametric infiltration (hazard ratio [HR], 7.668; P<0.05) and lymph node metastasis (HR, 7.714; P<0.05) were independent risk factors for all study patients.
  
  
  CONCLUSIONS
  Compared with RS, NACT-RS did not show a significant advantage for patients with locally advanced cervical cancer. However, the data provide the rationale for assessing NACT-RS in a multicenter randomized clinical trial setting. NACT may be considered as an alternative treatment when radiotherapy is not available.
authors.affiliation: Department of Obstetrics and Gynecology, West China Second Hospital, West China Center of Medical Sciences, Sichuan University, Chengdu, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Gong
authors.forename: Jian-Yan
authors.initials: JY
authors.lastname: Lou
authors.forename: Ping
authors.initials: P
authors.lastname: Wang
authors.forename: Jia-Wen
authors.initials: JW
authors.lastname: Zhang
authors.forename: Hui
authors.initials: H
authors.lastname: Liu
authors.forename: Zhi-Lan
authors.initials: ZL
authors.lastname: Peng
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology* / Q000628:therapy*; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D001761:Bleomycin / Q000008:administration & dosage / Q000031:analogs & derivatives; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D018572:Disease-Free Survival; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D007044:Hysterectomy; D007069:Ifosfamide / Q000008:administration & dosage; D053208:Kaplan-Meier Estimate; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009361:Neoplasm Invasiveness; D016016:Proportional Hazards Models; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000628:therapy*; D055815:Young Adult
chemical_list: D001761:Bleomycin; C025703:bleomycetin; D002945:Cisplatin; D005472:Fluorouracil; D007069:Ifosfamide