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01.04.2015 | Original Article | Ausgabe 2/2015

International Journal of Clinical Oncology 2/2015

Analysis of prognostic factors for patients with bulky squamous cell carcinoma of the uterine cervix who underwent neoadjuvant chemotherapy followed by radical hysterectomy

Zeitschrift:
International Journal of Clinical Oncology > Ausgabe 2/2015
Autoren:
Eriko Takatori, Tadahiro Shoji, Hideo Omi, Masahiro Kagabu, Fumiharu Miura, Satoshi Takeuchi, Seisuke Kumagai, Akira Yoshizaki, Akira Sato, Toru Sugiyama

Abstract

Background

Neoadjuvant chemotherapy (NAC) is not yet widely recommended for the treatment of stage I/II cervical cancer. However, it may be possible to achieve a favorable outcome by selecting appropriate patients. In the present study, prognostic factors were retrospectively investigated to obtain data for devising individualized NAC.

Patients and methods

The subjects were 33 patients with bulky stage Ib2–IIb squamous cell carcinoma (SCC) of the uterine cervix who gave consent and were scheduled to undergo radical hysterectomy. The patients intravenously received irinotecan 70 mg/m2 on days 1 and 8 and cisplatin 70 mg/m2 on day 1 of a 21-day course, and two courses were performed in principle. The potential prognostic factors investigated were age, performance status (PS), clinical stage, lymph node metastasis and tumor size before NAC, SCC antigen value, anti-tumor response, histological effect of NAC, lymph node metastasis in resected specimens, and postoperative adjuvant therapy after NAC. The impacts of these factors on overall survival (OS) were calculated with the Cox regression model.

Results

According to the univariate analysis, lymph node metastasis before NAC, SCC antigen value after NAC, anti-tumor response, and histological effect of NAC significantly influenced OS. These factors were tested in a multivariate model, and significant prognostic factors were lymph node metastasis before NAC (hazard ratio 0.116, P = 0.027) and anti-tumor response (hazard ratio 0.025, P = 0.003).

Conclusion

The presence or absence of lymph node metastasis by computed tomography imaging was the only significant prognostic factor identified during the pre-NAC period.

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