A retrospective study of neoadjuvant chemotherapy plus radical hysterectomy versus radical hysterectomy alone in patients with stage II cervical squamous cell carcinoma presenting as a bulky mass.
OBJECTIVE
In order to evaluate the usefulness of neoadjuvant chemotherapy (NAC) for stage II cervical squamous cell carcinoma with a bulky mass, we retrospectively compared patients receiving NAC followed by radical hysterectomy (RH; NAC group) with patients who underwent RH without NAC (Ope group).


METHODS
The study period was from June 2002 to March 2014. The subjects were 28 patients with a stage II bulky mass in the NAC group and 17 such patients in the Ope group. The chi-square test was used to compare operative time, volume of intraoperative blood loss, use of blood transfusion, and time from surgery to discharge between the two groups. Moreover, the log-rank test using the Kaplan-Meier method was performed to compare disease-free survival (DFS) and overall survival (OS) between the groups.


RESULTS
There were no statistically significant differences between the two groups in operative time, volume of intraoperative blood loss, or use of blood transfusion. However, the time from surgery to discharge was 18 days (14-25 days) in the NAC group and 25 days (21-34 days) in the Ope group; the patients in the NAC group were discharged earlier (P=0.032). The hazard ratio for DFS in the NAC group as compared with that in the Ope group was 0.36 (95% CI 0.08-0.91), and the 3-year DFS rates were 81.2% and 41.0%, respectively (P=0.028). Moreover, the hazard ratio for OS was 0.39 (95% CI 0.11-1.24), and the 3-year OS rates were 82.3% and 66.4%, respectively (P=0.101).


CONCLUSIONS
NAC with cisplatin and irinotecan was confirmed to prolong DFS as compared with RH alone. The results of this study suggest that NAC might be a useful adjunct to surgery in the treatment of stage II squamous cell carcinoma presenting as a bulky mass.
Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate, Japan.
Eriko
E
Takatori
Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate, Japan.
Tadahiro
T
Shoji
Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate, Japan.
Anna
A
Takada
Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate, Japan.
Takayuki
T
Nagasawa
Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate, Japan.
Hideo
H
Omi
Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate, Japan.
Masahiro
M
Kagabu
Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate, Japan.
Tatsuya
T
Honda
Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate, Japan.
Fumiharu
F
Miura
Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate, Japan.
Satoshi
S
Takeuchi
Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate, Japan.
Toru
T
Sugiyama
bulky mass; cervical cancer; neoadjuvant chemotherapy; prognosis
Eur J Gynaecol Oncol. 2003;24(1):51-9
12691318
Oncol Lett. 2010 May;1(3):515-519
22966335
Gynecol Oncol. 2008 Sep;110(3):308-15
18606439
J Natl Compr Canc Netw. 2010 Dec;8(12):1388-416
21147903
Int J Gynecol Cancer. 2009 Jul;19(5):943-7
19574789
Oncol Rep. 2012 Aug;28(2):487-93
22614251
Ann Surg Oncol. 2016 Jul;23(7):2176-82
26597364
Int J Gynaecol Obstet. 2009 May;105(2):103-4
19367689
Ann Surg Oncol. 2015 Dec;22 Suppl 3:S944-51
26268452
Br J Cancer. 2013 May 28;108(10):1957-63
23640393
Gynecol Oncol. 2007 Aug;106(2):362-9
17493669
Br J Cancer. 1999 Sep;81(1):95-8
10487618
J Clin Oncol. 2002 Jan 1;20(1):179-88
11773168
Cochrane Database Syst Rev. 2010 Jan 20;(1):CD008285
20091664