title: Efficacy of neoadjuvant chemotherapy plus radical surgery in patients with bulky stage II cervical squamous cell carcinoma: A retrospective cohort study.
abstract: OBJECTIVE
  In order to evaluate the usefulness of neoadjuvant chemotherapy (NAC) with cisplatin and taxol (PT) follow radical surgery for stage II cervical squamous cell carcinoma with a bulky mass.
  
  
  METHODS
  We retrospectively compared patients receiving NAC with PT followed by radical hysterectomy and pelvic lymph node dissection (RS) (NAC group) with patients only underwent RS without NAC (ORS group). Enrolled 35 patients with FIGO stage II markedly bulky in the NAC group and 30 such patients in the ORS group from January 2011 to December 2013. All patients histopathology were squamous cell carcinoma (SCC). The surgical profiles and complications, disease-free survival (DFS) and overall survival (OS) were compared between the groups.
  
  
  RESULTS
  There were no statistically significant differences between the two groups in age, BMI, tumor size, and FIGO stage. The response rate of NAC with PT was 82.8%. The two groups also had similar in operative time, blood transfusion. However, the estimated blood loss in ORS group was significantly higher compared to that in NAC group (P = 0.04). hospital stay of NAC group was shorter compared to ORS group (P = 0.03). The 3-year DFS rates were 84.9% and 65.6%, respectively, in the NAC and ORS groups. NAC significantly prolonged DFS (log-rank test, P = 0.03). Moreover, the OS tended to be longer in the NAC group, though the difference did not reach statistical significance (log-rank test, P = 0.287).
  
  
  CONCLUSIONS
  NAC with PT follow radical surgery was confirmed to prolong disease-free survival, as compared with radical hysterectomy alone. The results of this study suggest that NAC with PT might be a useful adjunct to surgery in the treatment of stage II SCC presenting as a bulky mass.
authors.affiliation: Department of Obstetrics and Gynecology, Gansu Provincial Hospital, Lanzhou, China. Electronic address: doctorTSQ@aliyun.com.
authors.forename: Tiansheng
authors.initials: T
authors.lastname: Qin
authors.affiliation: Department of Obstetrics and Gynecology, Gansu Provincial Hospital, Lanzhou, China.
authors.forename: Jieyu
authors.initials: J
authors.lastname: Zhen
authors.affiliation: Department of Obstetrics and Gynecology, Gansu Provincial Hospital, Lanzhou, China.
authors.forename: Meiying
authors.initials: M
authors.lastname: Zhou
authors.affiliation: Department of Obstetrics and Gynecology, Gansu Provincial Hospital, Lanzhou, China.
authors.forename: Huifang
authors.initials: H
authors.lastname: Wu
authors.affiliation: Department of Obstetrics and Gynecology, Gansu Provincial Hospital, Lanzhou, China.
authors.forename: Rui
authors.initials: R
authors.lastname: Ren
authors.affiliation: Department of Obstetrics and Gynecology, Gansu Provincial Hospital, Lanzhou, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Qu
authors.affiliation: Department of Obstetrics and Gynecology, Gansu Provincial Hospital, Lanzhou, China.
authors.forename: Hailin
authors.initials: H
authors.lastname: Wang
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D008197:Lymph Node Excision; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D017239:Paclitaxel / Q000008:administration & dosage; D012189:Retrospective Studies; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*
chemical_list: D017239:Paclitaxel; D002945:Cisplatin
keywords: Bulky mass; Cervical cancer; Neoadjuvant chemotherapy; Squamous cell carcinoma