Neoadjuvant chemotherapy and radical surgery compared to radical surgery alone in bulky stage IB–IIA cervical cancer

Behtash, Nadereh; Nazari, Zeinab; Ayatollahi, Haleh; Modarres, M.; Ghaemmaghami, Fatemeh; Mousavi, Azam Sadat

doi:10.1016/j.ejso.2006.07.012

Cited by 23 publications

(17 citation statements)

References 23 publications

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“…Of the patients who received neoadjuvant chemotherapy, 63-81% were treated postoperative concurrent chemoradiation. 18,31 In this study, a significantly lower proportion of patients treated with NAC received postoperative radiation (52.9% vs. 82.9%) than those undergoing PS. Despite this difference, the disease-free and overall survival rates in the two groups were not statistically different, although the NAC group had a tendency of higher 5-year disease-free survival rate than the PS group.…”

Section: Discussionmentioning

confidence: 93%

“…15 The discrepancies in these results may be due to a variety of clinical and biological factors, and the use of different chemotherapeutic regimens based on cisplatin. [15][16][17][18] Several new drug regimens may have more activity in cervical cancer. We therefore tested the efficacy of paclitaxel plus platinum neoadjuvant chemotherapy in patients with stage IB2 to IIA cervical cancer of size ＞4 cm, as evaluated by MRI, on pathologic prognostic factor and long-term survival.…”

Section: Introductionmentioning

confidence: 99%

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Comparative study of neoadjuvant chemotherapy before radical hysterectomy and radical surgery alone in stage IB2-IIA bulky cervical cancer

Cho

Kim

et al. 2009

J Gynecol Oncol

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Objective:To compare the efficacy of neoadjuvant chemotherapy with paclitaxel plus platinum followed by radical hysterectomy with radical surgery alone in patients with stage IB2-IIA bulky cervical cancer. Methods: From November 1999 to September 2007, stage IB2-IIA cervical cancers with tumor diameter ＞4 cm, as measured by MRI, were managed with two cycles of preoperative paclitaxel and platinum. As a control group, we selected 35 patients treated with radical surgery alone. Results: There were no significant between group differences in age, tumor size, FIGO stage, level of SCC Ag, histopathologic type and grade. Operating time, estimated blood loss, the number of lymph nodes yielded and the rate of complications were similar in the two groups. In surgical specimens, lymph-vascular space invasion (LVSI), nodal metastasis and parametrial involvement did not differ significantly between the two groups. In the neoadjuvant group, pathologic tumor size was significantly smaller and fewer patients had deep cervical invasion. Radiotherapy, alone and in the form of concurrent chemoradiation, was administered to more patients treated with radical surgery alone (82.9% vs. 52.9%, p=0.006). No recurrence was observed in patients who could avoid adjuvant radiotherapy owing to improved risk factors after neoadjuvant chemotherapy. There were no significant differences in 5-year disease free and overall survival. Conclusion: As neoadjuvant chemotherapy would improve pathologic prognostic factors, adjuvant radiotherapy can be avoided, without worsening the prognosis, in patients with locally advanced bulky cervical cancer. Neoadjuvant chemotherapy would be improving the quality of life after radical hysterectomy in patients with bulky cervical cancer.

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Section: Discussionmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Comparative study of neoadjuvant chemotherapy before radical hysterectomy and radical surgery alone in stage IB2-IIA bulky cervical cancer

Cho

Kim

et al. 2009

J Gynecol Oncol

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“…In the study by Hwang et al [10] positive lymph node was a significant factor for recurrence ,but initial tumor size, clinical response, and residual tumor size were not risk factors for recurrence after neoadjuvant chemotherapy. The prognostic significance of pelvic lymph node metastasis for recurrence had been confirmed again in the study by N Behtash et al [11] . In order to get the desirable effect of operation and to decrease postoperative metastasis and recurrence rate, arterial intubation interventional chemotherapy may be an important assistant regimen, even though it needs further study to testify if this procedure can be done as a routine in patients with late stages of cervical cancer.…”

Section: Discussionmentioning

confidence: 83%

Preoperative arterial interventional chemotherapy on cervical cancer

Wang

Linghu

Tang

et al. 2008

Chin. J. Cancer Res.

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Objective: To discuss the therapeutic effect of preoperative interventional chemotherapy on cervical cancer. Methods: Preoperative interventional chemotherapy by femoral intubation was performed in 25 patients with bulky cervical cancer. The patients received bleomycin 45 mg and cisplatin or oxaliplatin 80 mg/m 2 . Results: 25 cases (including 8 cases with stage I and 17 cases with stage II) received one or two courses of preoperative interventional chemotherapy. The size of the focal lesions was decreased greatly and radical hysterectomy and lymphadenectomy were performed successfully in all the patients. All of the specimens were sent for pathological examination. Lymphocyte infiltration was found more obvious in the cancer tissues as compared with their counterpart before treatment. As a result, relevant vaginal bleeding was stopped completely shortly after the treatment. Conclusion: Arterial interventional chemotherapy was proved to reduce the local size of cervical cancer and thus control the hemorrhage efficiently. The patients with cervical cancer can receive radical hysterectomy therapy after the interventional chemotherapy.

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“…It was thought that this was due to the increased resectability of patients receiving NACT (61/61 vs. 48/56 operable) versus the control. However, Behtash's [15] recent study found that NACT and surgery for bulky stage IB-IIA cervix cancer did not improve long-term overall survival of patients when compared to primary radical surgery alone [15][16][17][18].…”

Section: Neoadjuvant Chemotherapy For Stage Ib2 and Bulky Iia Cervicamentioning

confidence: 96%

Current management of stage IB2 and bulky IIA, locally advanced, and recurrent cervical carcinoma

Rodriguez

Ryu

et al. 2008

Oncol Rev

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Cervical cancer is one of the most common cancers affecting women, with most early disease treated with either surgery or radiation alone with an 85%-95% 5-year survival rate, while locally advanced cervical cancer (LACCA) requires multiple therapeutic modalities. The clear distinction between early and LACCA has, in recent years, blurred as stages IB2 and bulky IIA, which were traditionally thought of as early disease, have been shown to require more treatment than other early stage cervical cancer. LACC is now treated with cisplatin-based chemoradiation therapy based upon the results of the randomized co-operative group studies that demonstrated reduced relative risk of death, local failure rates, and incidence of distant metastases. Recurrent cervical cancer is devastating and is rarely cured. Treatment of recurrent cervical carcinoma depends on the previous therapy, the site of recurrence, and the extent of the recurrence. This review will outline the treatment options for the various stages of cervical cancer.

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Neoadjuvant chemotherapy and radical surgery compared to radical surgery alone in bulky stage IB–IIA cervical cancer

Cited by 23 publications

References 23 publications

Comparative study of neoadjuvant chemotherapy before radical hysterectomy and radical surgery alone in stage IB2-IIA bulky cervical cancer

Comparative study of neoadjuvant chemotherapy before radical hysterectomy and radical surgery alone in stage IB2-IIA bulky cervical cancer

Preoperative arterial interventional chemotherapy on cervical cancer

Current management of stage IB2 and bulky IIA, locally advanced, and recurrent cervical carcinoma

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