Patients treated with neoadjuvant chemotherapy + radical surgery + adjuvant chemotherapy in locally advanced cervical cancer: long-term outcomes, survival and prognostic factors in a single-center 10-year follow-up

Abstract

We report the long-term follow-up in patients with locally advanced cervical cancer treated with neoadjuvant chemotherapy (NACT) + radical surgery (RS) + adjuvant chemotherapy (ACT) analyzing prognostic factors which may more influence, in a long time, the survival outcome using univariate and multivariate analysis. In this study, we included all patients with diagnosis of locally advanced cervical cancer (IB2-IIB) treated with NACT + RS + ACT from June 2000 and February 2007 as previously described by Angioli et al. (Gynecol Oncol 127(2):290-6, 2012). The primary end-point of the study was overall survival (OS) in patients with node metastases and in those without positive lymph nodes at the end of 10-year follow-up in order to confirm the prognostic role of nodes involvement for a long period. Moreover, we analyzed the impact of other prognostic factors, such as histotype, tumor size, grading and parametrial invasion. Secondary end-point was evaluated in the subgroup of patients with positive nodes the following prognostic factors: number of positive lymph nodes and site of positive lymph nodes. In the subgroup of patients with positive nodes, the OS was 63 %, and in that with negative nodes, the OS was 75 %. On multivariate analysis, the number of nodal metastases, parametrial involvement, grading and the lesion diameter were noted to be significant factors in determining OS. Neither the histotype nor the lymph nodal site is related to survival. Results suggest that CT alone may be an alternative postoperative therapy for patients with cervical cancer.

Comparison of survival outcomes between radical hysterectomy and definitive radiochemotherapy in stage IB1 and IIA1 cervical cancer

“… 1 – 3 For patients with locally advanced CC, definitive radiochemotherapy is the standard treatment, 4 while neoadjuvant chemotherapy + radical surgery was also a choice of treatment. 5 – 8 The standard treatment for stage IB1 and IIA1 CC is radical hysterectomy, whereas radiotherapy (RT) with or without chemotherapy is currently reserved as an optional treatment for nonoperative patients. 9…”

PBX3 is associated with proliferation and poor prognosis in patients with cervical cancer

“… 27 Particularly in developing countries, such as China, CC ranks as the second most commonly diagnosed cancer and the third leading cause of cancer death for women. 28 Therefore, the development of new molecular methods to improve the diagnosis of CC and facilitate gene therapy is urgently required. 29 No sensitive biomarkers specific for the early detection and prognosis of CC have been reported to date.…”

Correspondence on the article: “Patients treated with neoadjuvant chemotherapy + radical surgery + adjuvant chemotherapy in locally advanced cervical cancer: long-term outcomes, survival and prognostic factors in a single-center 10-year follow-up”

“…Seventy percentage of patients in this series were having tumor size less than 4 cm and probably could be assigned as having low risk of distant metastases and were in any case candidates for surgery [1].…”

“…Our team has gone through this article authored by Luvero et al [1]. Certainly, 10-year follow-up of 90 cervical cancer patients is an impressive long-term follow-up.…”