title: Matched-case comparison of neoadjuvant chemotherapy in patients with FIGO stage IB1-IIB cervical cancer to establish selection criteria.
abstract: OBJECTIVE
  Neoadjuvant chemotherapy (NACT) for cervical cancer still remains controversial. NACT was evaluated to establish selection criteria.
  
  
  METHODS
  A matched-case comparison was designed for the NACT group (n=707) and primary surgery treatment (PST; n=707) group to investigate short-term responses and high/intermediate risk factors (HRFs/IRFs). The 5-year disease-free survival (DFS) and overall survival (OS) rates were stratified by NACT response, HRFs/IRFs, International Federation of Gynecology and Obstetrics (FIGO) stage and tumour size, respectively.
  
  
  RESULTS
  The clinical and pathological response rates were 79.3% and 14.9% in the NACT group. In comparison to the PST group, IRFs but not HRFs were significantly decreased (P<0.05), and the 5-year DFS rate was significantly improved in the NACT group (88.4% versus 83.1%, P=0.021). Moreover, the 5-year DFS and OS rates were favourably increased in the clinical responders in comparison to the PST group and the clinical non-responders (P<0.05). Compared to those of clinical non-responders, the 5-year DFS and OS rates of clinical responders, with or without HRFs, were also significantly increased (P<0.01). In stage IB2, the 5-year DFS and OS rates were significantly increased, whereas operation duration declined in the NACT group (P<0.05). For patients with stage IB tumours of 2-5 cm, the 5-year DFS and OS rates of clinical responders were significantly improved (P<0.05).
  
  
  CONCLUSIONS
  NACT is a suitable option for patients with cervical cancer, especially for NACT responders and patients with stage IB, which provides a new concept of fertility preservation for young patients.
authors.affiliation: Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China.
authors.forename: Ting
authors.initials: T
authors.lastname: Hu
authors.forename: Shuang
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authors.lastname: Li
authors.forename: Yile
authors.initials: Y
authors.lastname: Chen
authors.forename: Jian
authors.initials: J
authors.lastname: Shen
authors.forename: Xiong
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authors.forename: Kecheng
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authors.lastname: Huang
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authors.lastname: Wu
authors.forename: Zhilan
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authors.lastname: Chen
authors.forename: Yao
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authors.lastname: Jia
authors.forename: Shaoshuai
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authors.lastname: Wang
authors.forename: Xiaodong
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authors.lastname: Cheng
authors.forename: Xiaobing
authors.initials: X
authors.lastname: Han
authors.forename: Zhongqiu
authors.initials: Z
authors.lastname: Lin
authors.forename: Hui
authors.initials: H
authors.lastname: Xing
authors.forename: Pengpeng
authors.initials: P
authors.lastname: Qu
authors.forename: Hongbing
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authors.lastname: Cai
authors.forename: Xiaojie
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authors.forename: Xiaoyu
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authors.lastname: Tian
authors.forename: Hongbing
authors.initials: H
authors.lastname: Xu
authors.forename: Jun
authors.initials: J
authors.lastname: Xu
authors.forename: Qinghua
authors.initials: Q
authors.lastname: Zhang
authors.forename: Ling
authors.initials: L
authors.lastname: Xi
authors.forename: Dongrui
authors.initials: D
authors.lastname: Deng
authors.forename: Hui
authors.initials: H
authors.lastname: Wang
authors.forename: Shixuan
authors.initials: S
authors.lastname: Wang
authors.forename: Weiguo
authors.initials: W
authors.lastname: Lv
authors.forename: Changyu
authors.initials: C
authors.lastname: Wang
authors.forename: Xing
authors.initials: X
authors.lastname: Xie
authors.forename: Ding
authors.initials: D
authors.lastname: Ma
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D017024:Chemotherapy, Adjuvant; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D012307:Risk Factors; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery