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01.08.2011 | Gynecologic Oncology

Treatment of stage IB2, IIA bulky cervical cancer: a single-institution experience of neoadjuvant chemotherapy followed by radical hysterectomy and primary radical hysterectomy

verfasst von: Jung-Yun Lee, Yun Hwan Kim, Min-Jeong Kim, Kidong Kim, Hyun Hoon Chung, Noh-Hyun Park, Yong-Sang Song, Soon-Beom Kang

Erschienen in: Archives of Gynecology and Obstetrics | Ausgabe 2/2011

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Abstract

Introduction

The aim of this study was to compare the efficacy and safety of neoadjuvant chemotherapy (NAC) followed by radical hysterectomy (NAC group) with primary radical hysterectomy (RH group).

Methods

We reviewed all patients with bulky stage IB-IIA cervical cancer treated at Seoul National University Hospital from January 1, 2000 to December 31, 2006. Thirty-three patients were treated with NAC prior to radical hysterectomy, and 41 patients were treated with radical hysterectomy.

Results

Clinical characteristics were not significantly different between the two groups. The response rate in the NAC group was 81.8%. Operation time, estimated blood loss, and complication rate were not significantly different between the two groups. Pathologic outcomes were improved in the NAC group. Adjuvant therapy was less frequently performed in the NAC group (51.6%) than in the RH group (82.9%) (P = 0.005). The 5-year progression-free survival was 90.7% in the NAC group and 81.3% in the RH group, but the difference was not statistically significant (P = 0.297).

Conclusion

The results of this study suggest that NAC may improve pathologic outcomes, decrease the need for adjuvant radiation therapy and have a comparable operation feasibility without affecting progression-free survival.

Perez CA, Grigsby PW, Nene SM, Camel HM, Galakatos A, Kao MS, Lockett MA (1992) Effect of tumor size on the prognosis of carcinoma of the uterine cervix treated with irradiation alone. Cancer 69:2796–2806PubMedCrossRef

Alvarez RD, Soong SJ, Kinney WK, Reid GC, Schray MF, Podratz KC, Morley GW, Shingleton HM (1989) Identification of prognostic factors and risk groups in patients found to have nodal metastasis at the time of radical hysterectomy for early-stage squamous carcinoma of the cervix. Gynecol Oncol 35:130–135PubMedCrossRef

Eifel PJ, Morris M, Wharton JT, Oswald MJ (1994) The influence of tumor size and morphology on the outcome of patients with FIGO stage IB squamous cell carcinoma of the uterine cervix. Int J Radiat Oncol Biol Phys 29:9–16PubMedCrossRef

Landoni F, Maneo A, Colombo A, Placa F, Milani R, Perego P, Favini G, Ferri L, Mangioni C (1997) Randomised study of radical surgery versus radiotherapy for stage IB-IIA cervical cancer. Lancet 350:535–540PubMedCrossRef

Friedlander ML, Atkinson K, Coppleson JV, Elliot P, Green D, Houghton R, Solomon HJ, Russell P, Tattersall MH (1984) The integration of chemotherapy into the management of locally advanced cervical cancer: a pilot study. Gynecol Oncol 19:1–7PubMedCrossRef

Ryu HS, Kang SB, Kim KT, Chang KH, Kim JW, Kim JH (2007) Efficacy of different types of treatment in FIGO stage IB2 cervical cancer in korea: results of a multicenter retrospective korean study (KGOG-1005). Int J Gynecol Cancer 17:132–136PubMedCrossRef

Napolitano U, Imperato F, Mossa B, Framarino ML, Marziani R, Marzetti L (2003) The role of neoadjuvant chemotherapy for squamous cell cervical cancer (IB-IIIB): a long-term randomized trial. Eur J Gynaecol Oncol 24:51–59PubMed

Cai HB, Chen HZ, Yin HH (2006) Randomized study of preoperative chemotherapy versus primary surgery for stage IB cervical cancer. J Obstet Gynaecol Res 32:315–323PubMedCrossRef

Sardi JE, Giaroli A, Sananes C, Ferreira M, Soderini A, Bermudez A, Snaidas L, Vighi S, Gomez Rueda N, di Paola G (1997) Long-term follow-up of the first randomized trial using neoadjuvant chemotherapy in stage IB squamous carcinoma of the cervix: the final results. Gynecol Oncol 67:61–69PubMedCrossRef

10.

Eddy GL, Bundy BN, Creasman WT, Spirtos NM, Mannel RS, Hannigan E, O’Connor D (2007) Treatment of (“Bulky”) stage IB cervical cancer with or without neoadjuvant vincristine and cisplatin prior to radical hysterectomy and pelvic/para-aortic lymphadenectomy: a phase III trial of the gynecologic oncology group. Gynecol Oncol 106:362–369PubMedCrossRef

11.

Selvaggi L, Loizzi V, DIG AR, Nardelli C, Cantatore C, Cormio G (2006) Neoadjuvant chemotherapy in cervical cancer: a 67 patients experience. Int J Gynecol Cancer 16:631–637PubMedCrossRef

12.

Benedetti-Panici P, Greggi S, Colombo A, Amoroso M, Smaniotto D, Giannarelli D, Amunni G, Raspagliesi F, Zola P, Mangioni C, Landoni F (2002) Neoadjuvant chemotherapy and radical surgery versus exclusive radiotherapy in locally advanced squamous cell cervical cancer: results from the italian multicenter randomized study. J Clin Oncol 20:179–188PubMedCrossRef

13.

Duenas-Gonzalez A, Lopez-Graniel C, Gonzalez-Enciso A, Cetina L, Rivera L, Mariscal I, Montalvo G, Gomez E, de la Garza J, Chanona G, Mohar A (2003) A phase ii study of multimodality treatment for locally advanced cervical cancer: neoadjuvant carboplatin and paclitaxel followed by radical hysterectomy and adjuvant cisplatin chemoradiation. Ann Oncol 14:1278–1284PubMedCrossRef

14.

Park DC, Suh MJ, Yeo SG (2009) Neoadjuvant paclitaxel and cisplatin in uterine cervical cancer: long-term results. Int J Gynecol Cancer 19:943–947PubMedCrossRef

15.

Zanetta G, Lissoni A, Pellegrino A, Sessa C, Colombo N, Gueli-Alletti D, Mangioni C (1998) Neoadjuvant chemotherapy with cisplatin, ifosfamide and paclitaxel for locally advanced squamous-cell cervical cancer. Ann Oncol 9:977–980PubMedCrossRef

16.

Termrungruanglert W, Tresukosol D, Vasuratna A, Sittisomwong T, Lertkhachonsuk R, Sirisabya N (2005) Neoadjuvant gemcitabine and cisplatin followed by radical surgery in (bulky) squamous cell carcinoma of cervix stage IB2. Gynecol Oncol 97:576–581PubMedCrossRef

17.

Kokawa K, Nishimura R, Fujii T, Umesaki N (2007) Neoadjuvant chemotherapy with irinotecan and mitomycin-c for locally advanced squamous cell carcinoma of the uterine cervix. Anticancer Res 27:2721–2727PubMed

18.

Sedlis A, Bundy BN, Rotman MZ, Lentz SS, Muderspach LI, Zaino RJ (1999) A randomized trial of pelvic radiation therapy versus no further therapy in selected patients with stage IB carcinoma of the cervix after radical hysterectomy and pelvic lymphadenectomy: a gynecologic oncology group study. Gynecol Oncol 73:177–183PubMedCrossRef

19.

Cho YH, Kim DY, Kim JH, Kim YM, Kim YT, Nam JH (2009) Comparative study of neoadjuvant chemotherapy before radical hysterectomy and radical surgery alone in stage IB2-IIA bulky cervical cancer. J Gynecol Oncol 20:22–27PubMedCrossRef

20.

Paladini D, Raspagliesi F, Fontanelli R, Ntousias V (1995) Radical surgery after induction chemotherapy in locally advanced cervical cancer. a feasibility study. Int J Gynecol Cancer 5:296–300PubMedCrossRef

21.

Rydzewska L, Tierney J, Vale CL, Symonds PR (2010) Neoadjuvant chemotherapy plus surgery versus surgery for cervical cancer. Cochrane Database Syst Rev CD007406

Titel: Treatment of stage IB2, IIA bulky cervical cancer: a single-institution experience of neoadjuvant chemotherapy followed by radical hysterectomy and primary radical hysterectomy
verfasst von: Jung-Yun Lee
Yun Hwan Kim
Min-Jeong Kim
Kidong Kim
Hyun Hoon Chung
Noh-Hyun Park
Yong-Sang Song
Soon-Beom Kang
Publikationsdatum: 01.08.2011
Verlag: Springer-Verlag
Erschienen in: Archives of Gynecology and Obstetrics / Ausgabe 2/2011
Print ISSN: 0932-0067
Elektronische ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-010-1685-9

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Treatment of stage IB2, IIA bulky cervical cancer: a single-institution experience of neoadjuvant chemotherapy followed by radical hysterectomy and primary radical hysterectomy