Yy. Hwang et al., Ten-year survival of patients with locally advanced, stage IB-IIB cervicalcancer after neoadjuvant chemotherapy and radical hysterectomy, GYNECOL ONC, 82(1), 2001, pp. 88-93
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.