Analysis of prognostic factors in patients with stageⅠB2-ⅡA2 uterine cervical cancer treated with a combintion of neoadjuvant chemotherapy and surgery / 中国癌症杂志

ABSTRACT

Background and purpose:The aim of this study was to analyze the prognostic factors in uterine adenocarcinoma and adenosquamous carcinoma treated with a combination of neoadjuvant chemoradiotherapy and surgery.Methods:Clinicopathologic data from 50 patients with stageⅠB2-ⅡA2 uterine cervical cancer were collected from the First Afifliated Hospital of Bengbu Medical College between Apr. 2005 and Oct. 2011. All patients underwent neoajuvant chemoradiotherapy, followed by radical hysterectomy and pelvic lymph node dissection. Before surgery, an intravenous chemotherapy was given. A particular vaginal brachytherapy was given to those with tumor diameter≥6 cm. The survival and recurrence in patients were analyzed retrospectively to investigate the prognostic factors. Results:In 50 patients withⅠB2-ⅡA2 uterine adenocarcinoma and adenosquamous carcinoma, 15 died during the follow-up period. The 2-year and 5-year progression-free survival rates were 80.12% and 72.24%, respectively, and median progression-free survival was 68 months. The 2-year and 5-year overall survival rates were 95.38% and 73.56%, respectively, and median overall survival was 80 months. Univariate analysis revealed that pelvic lymph node metastasis, cervical stromal invasion, parametrial infiltration, tumor diameter reduction 0.05). Multivariate Cox proportional analysis revealed that pelvic lymph node metastasis and tumor diameter reduction after radiation and chemotherapy were the independent prognostic factors in patients with cervical cancer. Conclusion:The combination of neoadjuvant chemotherapy and surgery improves the resectable rate of patients withⅠB2-ⅡA2 uterine adenocarcinoma and adenosquamous carcinoma. Pelvic lymph node metastasis and tumor diameter reduction after radiation and chemotherapy are the independent prognostic factors in patients with cervical cancer.