Ten-Year Survival of Patients with Locally Advanced, Stage IB–IIB Cervical Cancer after Neoadjuvant Chemotherapy and Radical Hysterectomy

Use of neoadjuvant chemotherapy prior to radical hysterectomy in cervical cancer: monitoring tumour shrinkage and molecular profile on magnetic resonance and assessment of 3-year outcome

“…Lymph node involvement in both groups was twice that was quoted for similar stage tumours in the literature. In other reports, for tumours clinically assessed as 44 cm diameter, a 11 -25% lymph node involvement resulted in overall 5-year survival figures between 82 and 74% (Eddy et al, 1995;Sardi et al, 1997;Benedetti-Panici et al, 1998;Hwang et al, 2001). Similarly, a randomised study by Chang et al (2000), comparing neoadjuvant chemotherapy followed by radical hysterectomy with radical radiotherapy in bulky stage I disease, showed a 2-year cumulative survival of 81% for the neoadjuvant chemotherapy arm, but no significant difference between that and the control arm in disease-free or overall survival.…”

“…In addition, it may serve to control micrometastatic disease and so improve survival. Previous studies have relied on clinical evaluation by pelvic examination with or without ultrasonography to assess the response (Eddy et al, 1995;Lai et al, 1997;Sardi et al, 1997;Benedetti-Panici et al, 1998;Hwang et al, 2001). Reductions in tumour volume of up to 100% with as many as 15 -20% having complete clinical response after three cycles of chemotherapy (Lai et al, 1997;Benedetti-Panici et al, 1998) have been reported, but on comparison with subsequent histopathology these assessments have been shown to be inaccurate (Eddy et al, 1995).…”

“…Regimes described vary from single agent cisplatin 40 mg m À2 to double or triple agent therapy combining cisplatin 43 -80 mg m À2 with bleomycin 15 -30 mg m À2 and with the addition of vinblastine 4 mg m À2 or vincristine 1 mg m À2 . Numbers of cycles varied between two and six, with reports of continued response up to five cycles (Hwang et al, 2001). We used a regimen from Benedetti-Panici et al (1991), modified from three times weekly to twice weekly, with a reduced dose of cisplatin.…”

“…Neoadjuvant chemotherapy has been advocated prior to radical hysterectomy in locally advanced cervical carcinoma because it may serve to control micrometastatic disease and so improve survival (Sardi et al, 1997;Benedetti-Panici et al, 1998;Hwang et al, 2001). In addition, it offers the potential to reduce tumour volume and thus improve surgical resectability (Eddy et al, 1995).…”

Preoperative Chemotherapy for Infiltrative Low-Grade Oligoastrocytoma: a Useful Strategy to Maximize Surgical Resection -Case Report-

“…3,10,14,20,24,25,28) If neoadjuvant chemotherapy reduces tumor volume and infiltration, surgery allows further cytoreduction, as demonstrated in solid neoplasms of other tissues such as the lung, testicle, and breast. 7,9,16) The combination of neoadjuvant chemotherapy and surgery to treat cerebral LGG has been reported only in a patient with a low-grade oligodendroglioma that progressed after prior partial surgical resection. 6) Similar to our case, chemotherapy achieved regression of the contralateral diffusion, leading to a second radical surgery.…”