Ten-year survival of patients with locally advanced, stage IB-IIB cervicalcancer after neoadjuvant chemotherapy and radical hysterectomy

Objective(s). The aim of this study was to evaluate the effects of neoadjuv ant chemotherapy and radical hysterectomy on longterm survival in stage IB- IIB locally advanced cervical cancer by conducting a 10-year follow-up. Methods. Between August 1983 and May 1990, 80 focally advanced, stage IB-II B cervical cancer patients with tumor diameter greater than or equal to 4 c m were treated with neoadjuvant VBP chemotherapy (cisplatin, vinblastine, a nd bleomycin) followed by radical hysterectomy with pelvic lymphadenectomy. After this therapeutic modality, patients were followed for more than 10 y ears. Ten-year survival rates and factors affecting recurrence after this t herapy were evaluated. Results. Of 80 patients, 75 (93.7%) showed a reduction in tumor size after neoadjuvant chemotherapy. At pathologic examination, stage reduction was no ted in 53 (66.2%) patients and 20 patients (25%) showed no residual or micr oinvasive cervical tumor. Pelvic lymph node metastases were found in 17 pat ients (21.3%). During the 10-year follow up, 2 patients were lost and 16 pa tients recurred. Overall 5-year and 10-year disease-free actual survival ra tes were 82.0 (64/78) and 79.4% (62/78), respectively. Clinical stage, init ial tumor size, clinical response, and residual tumor size were not risk fa ctors for recurrence after this therapy. However, pelvic lymph node metasta sis was a significant risk factor for recurrence. Conclusion(s). Neoadjuvant VBP chemotherapy followed by radical hysterectom y in locally advanced, stage IB-IIB cervical cancer patients seemed to impr ove the long-term survival rate for these patients compared to that of conv entional therapy. However, randomized controlled trials are needed to confi rm this result. (C) 2001 Academic Press.