Clinical evaluation of neoadjuvant chemotherapy followed by radical surgery in the management of stage IB2–IIB cervical cancer

Abstract

ObjectiveTo evaluate clinical efficacy, toxicity, and survival outcomes of neoadjuvant chemotherapy (NACT) followed by radical surgery (RS) among patients with cervical cancer stage IB2–IIB. MethodsIn 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. ResultsThe 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. ConclusionCompared 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.