Efficacy of neoadjuvant chemotherapy plus radical surgery in patients with bulky stage II cervical squamous cell carcinoma: A retrospective cohort study

Abstract

ObjectiveIn 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. Materials and methodsWe 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. ResultsThere 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). ConclusionsNAC 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.