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

• Published in: Gynecologic oncology 2001-07, Vol.82 (1), p.88-93
• Main Authors: Hwang, Youn Yeoung, Moon, Hyung, Cho, Sam Hyun, Kim, Kyung Tai, Moon, Young Jin, Kim, Seung Ryong, Kim, Doo Sang
• Format: Article
• Language: English
• Subjects: Adenocarcinoma - classification; Adenocarcinoma - mortality; Adenocarcinoma - therapy; Adult; Aged; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological and medical sciences; Bleomycin - therapeutic use; Carcinoma, Adenosquamous - classification; Carcinoma, Adenosquamous - mortality; Carcinoma, Adenosquamous - therapy; Carcinoma, Squamous Cell - classification; Carcinoma, Squamous Cell - mortality; Carcinoma, Squamous Cell - therapy; Chemotherapy, Adjuvant; Cisplatin - therapeutic use; Combined Modality Therapy; Disease-Free Survival; Female; Humans; Hysterectomy; Lymphatic Metastasis; Medical sciences; Middle Aged; Neoplasm Recurrence, Local; Neoplasm Staging; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the genital tract and mammary gland; Survival Rate; Treatment Outcome; Uterine Cervical Neoplasms - classification; Uterine Cervical Neoplasms - mortality; Uterine Cervical Neoplasms - therapy; Vinblastine - therapeutic use
• ISSN: 0090-8258; 1095-6859
• DOI: 10.1006/gyno.2001.6204

Objective(s). The aim of this study was to evaluate the effects of neoadjuvant chemotherapy and radical hysterectomy on long-term survival in stage IB–IIB locally advanced cervical cancer by conducting a 10-year follow-up. Methods. Between August 1983 and May 1990, 80 locally advanced, stage IB–IIB cervical cancer patients with tumor diameter greater than or equal to 4 cm were treated with neoadjuvant VBP chemotherapy (cisplatin, vinblastine, and bleomycin) followed by radical hysterectomy with pelvic lymphadenectomy. After this therapeutic modality, patients were followed for more than 10 years. Ten-year survival rates and factors affecting recurrence after this therapy were evaluated. Results. Of 80 patients, 75 (93.7%) showed a reduction in tumor size after neoadjuvant chemotherapy. At pathologic examination, stage reduction was noted in 53 (66.2%) patients and 20 patients (25%) showed no residual or microinvasive cervical tumor. Pelvic lymph node metastases were found in 17 patients (21.3%). During the 10-year follow up, 2 patients were lost and 16 patients recurred. Overall 5-year and 10-year disease-free actual survival rates were 82.0 (64/78) and 79.4% (62/78), respectively. Clinical stage, initial tumor size, clinical response, and residual tumor size were not risk factors for recurrence after this therapy. However, pelvic lymph node metastasis was a significant risk factor for recurrence. Conclusion(s). Neoadjuvant VBP chemotherapy followed by radical hysterectomy in locally advanced, stage IB–IIB cervical cancer patients seemed to improve the long-term survival rate for these patients compared to that of conventional therapy. However, randomized controlled trials are needed to confirm this result.