COMPARATIVE-STUDY OF THE PATIENTS WITH LOCALLY ADVANCED STAGE-I AND STAGE-II CERVICAL-CANCER TREATED BY RADICAL SURGERY WITH AND WITHOUT PREOPERATIVE ADJUVANT CHEMOTHERAPY

Ninty-two patients with locally advanced stages IB, IIA, and IIB cervi cal cancers, who had completed 4 years of follow-up after treatment wi th preoperative adjuvant chemotherapy prior to radical surgery, were c ompared with 138 patients in same disease status who were treated with radical surgery without preoperative adjuvant chemotherapy. In the pa tients treated with preoperative adjuvant chemotherapy (VBP scheme), t he chemotherapeutic response was more favorable in squamous cell carci nomas (87%) than that in adenocarcinomas (38%). The detection rate of pelvic lymph node metastasis from the surgical specimens of radical op eration was higher in the patients of radical surgery without preopera tive chemotherapy (34%; 47/138) than that in the preoperative adjuvant chemotherapeutic patients (17%; 16/92, P = 0.005). Recurrence occurre d in 50 of 138 patients (35.5%) who were treated by radical surgery wi thout preoperative chemotherapy and in 17 of 92 patients (18.5%) who w ere treated with preoperative adjuvant chemotherapy followed by radica l surgery. The difference of recurrence rate between two groups was st atistically significant (P = 0.004). The tumor-free survival of preope rative adjuvant chemotherapeutic patients was significantly longer tha n those in the patients without preoperative chemotherapy (P = 0.0067) . Tumor response to chemotherapy was a valuable prognostic factor in m anagement of patients and preoperative adjuvant chemotherapy was benef icial in reducing pelvic lymph node metastases, reducing recurrences, and prolonging the survival of the patients with locally advanced cerv ical cancers, especially in stage IIA. (C) 1995 Academic Press, Inc.