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Neoadjuvant chemotherapy followed by radical hysterectomy for stage IB2-to-IIB cervical cancer: a retrospective cohort study

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International Journal of Clinical Oncology Aims and scope Submit manuscript

Abstract

Introduction

This study was to evaluate the surgical and survival effects of neoadjuvant chemotherapy (NAC) followed by radical hysterectomy (RH) for cervical cancer with stages IB2 to IIB of FIGO 2009 staging.

Methods

From February 2, 2001 to November 11, 2015, 428 patients received NAC followed by RH in a tertiary hospital, in which all the major procedures were performed by one surgeon. Surgical and survival outcomes were evaluated between the NAC and primary RH groups.

Results

A total of 279 (65.2%) patients received NAC, and the overall clinical and complete pathological response rates were 65.9% and 10.8%, respectively. Compared with primary RH patients, NAC patients had more advanced stages, higher recurrence rate, longer median duration of RH, and more median estimated blood loss. After adjusted with baseline risk factors, no significant differences in progression-free or overall survival were observed between the NAC and primary RH groups. However, the responders to NAC had better survival outcomes.

Conclusions

There were no surgical or survival benefits of NAC for patients with cervical cancer of stages IB2 to IIB except for the responders to NAC.

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Abbreviations

LACC:

Locally advanced cervical cancer

NAC:

Neoadjuvant chemotherapy

OS:

Overall survival

PALN:

Para-aortic lymph nodes

PF:

Fluorouracil and cisplatin

PFS:

Progression-free survival

PLN:

Pelvic lymph node

RH:

Radical hysterectomy

TC:

Paclitaxel and carboplatin

TP:

Paclitaxel and cisplatin

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Funding

This work was supported by the Chinese Academy of Medical Sciences Initiative for Innovative Medicine (no. CAMS-2017-I2M-1-002). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Shuaifuyuan No. 1, Dongcheng District, Beijing, 100730, China

    Lei Li, Ming Wu, Shuiqing Ma, Xianjie Tan & Sen Zhong

Authors
  1. Lei Li
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  2. Ming Wu
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  3. Shuiqing Ma
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  4. Xianjie Tan
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  5. Sen Zhong
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Contributions

LL: assistant surgeon, protocol/project development, data management, data analysis, and manuscript drafting; MW: major surgeon and manuscript editing; SM, XT, SZ: assistant surgeons and data management.

Corresponding author

Correspondence to Ming Wu.

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Li, L., Wu, M., Ma, S. et al. Neoadjuvant chemotherapy followed by radical hysterectomy for stage IB2-to-IIB cervical cancer: a retrospective cohort study. Int J Clin Oncol 24, 1440–1448 (2019). https://doi.org/10.1007/s10147-019-01510-1

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