S-Space College of Medicine/School of Medicine (의과대학/대학원) Obstetrics & Gynecology (산부인과전공) Journal Papers (저널논문_산부인과학전공)
Matched-case comparison for the efficacy of neoadjuvant chemotherapy before surgery in FIGO stage IB1-IIA cervical cancer
- Kim, Hee Seung; Kim, Ju Yeong; Park, Noh Hyun; Kim, Kidong; Kim, Yong Beom; Kim, Hak Jae; Kang, Soon-Beom; Song, Yong Sang; Kim, Jae Weon; Chung, Hyun Hoon
- Issue Date
- ACADEMIC PRESS INC ELSEVIER SCIENCE
- GYNECOLOGIC ONCOLOGY; Vol.119 2; 217-224
- Neoadjuvant chemotherapy before surgery; FIGO stage IB1-IIA cervical cancer; Primary surgical treatment
- Objective. To evaluate whether neoadjuvant chemotherapy before surgery (NCS) is more efficient than primary surgical treatment (PST) for improving clinical outcomes in FIGO stage IB1-IIA cervical cancer. Methods. We conducted a matched-case comparison where 61 patients treated with NCS were matched to 183 treated with PST. We compared intermediate- and high-risk factors, the need of adjuvant radiotherapy, disease recurrence and survivals between NCS and PST. Patients with >= 2 intermediate- or >= 1 high-risk factors received adjuvant concurrent chemoradiation using cisplatin-based chemotherapy. Results. NCS reduced more definitely intermediate- and high-risk factors than PST in stage IIA disease in spite of little difference of them in stage IB disease (large tumor size, 25% vs. 52.4%; deep stromal invasion, 57.1% vs. 82.1%; lymphovascular space invasion, 35.7% vs. 65.5%; parametrial invasion, 17.9% vs. 41.7%; p<0.05). Moreover, >= 2 intermediate-risk factors were less common in NCS than PST despite no difference of the number of high-risk factors between the 2 treatments, which decreased the need of adjuvant radiotherapy in patients with stage IIA disease who received NCS (46.4% vs. 84.5%, p<0.01). Although there were no differences in progression-free survival and disease recurrence between the 2 treatments, NCS led to poorer overall survival than PST in stage IIA disease with no difference of it in stage IB disease. Conclusions. The efficacy between NCS and PST may be similar in FIGO stage IB cervical cancer. However, NCS can lead to poor prognosis despite the reduction of intermediate-risk factors and the need of adjuvant radiotherapy in FIGO stage IIA disease. (C) 2010 Elsevier Inc. All rights reserved.
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