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Neoadjuvant chemotherapy followed by surgery has no therapeutic advantages over concurrent chemoradiotherapy in International Federation of Gynecology and Obstetrics stage IB-IIB cervical cancer / 부인종양
Journal of Gynecologic Oncology ; : e52-2016.
Article in English | WPRIM | ID: wpr-216445
ABSTRACT

OBJECTIVE:

We aimed to assess the efficacy of neoadjuvant chemotherapy followed by surgery (NACT+S), and compared the clinical outcome with that of concurrent chemoradiotherapy (CCRT) in patients with International Federation of Gynecology and Obstetrics (FIGO) IB-IIB cervical cancer.

METHODS:

We reviewed 85 patients with FIGO IB-IIB cervical cancer who received NACT+S between 1989 and 2012, and compared them to 358 control patients who received CCRT. The clinical application of NACT was classified based on the following possible therapeutic benefits increasing resectability after NACT by reducing tumor size or negative conversion of node metastasis; downstaging adenocarcinoma regarded as relatively radioresistant; and preservation of fertility through limited surgery after NACT.

RESULTS:

Of 85 patients in the NACT+S group, the pathologic downstaging and complete response rates were 68.2% and 22.6%, respectively. Only two young patients underwent limited surgery for preservation of fertility. Patients of the NACT+S group were younger, less likely to have node metastasis, and demonstrated a higher proportion of FIGO IB cases than those of the CCRT group (p≤0.001). The 5-year locoregional control, progression-free survival, and overall survival rates in the NACT+S group were 89.7%, 75.6%, and 92.1%, respectively, which were not significantly different from the rates of 92.5%, 74%, and 84.9% observed in the CCRT group, respectively (p>0.05).

CONCLUSION:

NACT+S has no therapeutic advantages over CCRT, the standard treatment. Therefore, NACT+S should be considered only in selected patients through multidisciplinary discussion or clinical trial setting.
Subject(s)

Full text: Available Index: WPRIM (Western Pacific) Main subject: Uterine Cervical Neoplasms / Retrospective Studies / Treatment Outcome / Chemotherapy, Adjuvant / Neoadjuvant Therapy / Chemoradiotherapy / Hysterectomy / Neoplasm Staging Type of study: Observational study Limits: Adult / Aged / Aged80 / Female / Humans Language: English Journal: Journal of Gynecologic Oncology Year: 2016 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Main subject: Uterine Cervical Neoplasms / Retrospective Studies / Treatment Outcome / Chemotherapy, Adjuvant / Neoadjuvant Therapy / Chemoradiotherapy / Hysterectomy / Neoplasm Staging Type of study: Observational study Limits: Adult / Aged / Aged80 / Female / Humans Language: English Journal: Journal of Gynecologic Oncology Year: 2016 Type: Article