Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Shuaifuyuan No. 1, Dongcheng District, Beijing, 100730, China.
Int J Clin Oncol. 2019 Nov;24(11):1440-1448. doi: 10.1007/s10147-019-01510-1. Epub 2019 Jul 15.
This study was to evaluate the surgical and survival effects of neoadjuvant chemotherapy (NAC) followed by radical hysterectomy (RH) for cervical cancer with stages IB2 to IIB of FIGO 2009 staging.
From February 2, 2001 to November 11, 2015, 428 patients received NAC followed by RH in a tertiary hospital, in which all the major procedures were performed by one surgeon. Surgical and survival outcomes were evaluated between the NAC and primary RH groups.
A total of 279 (65.2%) patients received NAC, and the overall clinical and complete pathological response rates were 65.9% and 10.8%, respectively. Compared with primary RH patients, NAC patients had more advanced stages, higher recurrence rate, longer median duration of RH, and more median estimated blood loss. After adjusted with baseline risk factors, no significant differences in progression-free or overall survival were observed between the NAC and primary RH groups. However, the responders to NAC had better survival outcomes.
There were no surgical or survival benefits of NAC for patients with cervical cancer of stages IB2 to IIB except for the responders to NAC.
本研究旨在评估新辅助化疗(NAC)联合根治性子宫切除术(RH)治疗 FIGO 2009 分期 IB2 至 IIB 期宫颈癌的手术和生存效果。
2001 年 2 月 2 日至 2015 年 11 月 11 日,428 例患者在一家三级医院接受 NAC 联合 RH,所有主要手术均由一位外科医生完成。评估了 NAC 组和原发性 RH 组之间的手术和生存结果。
共有 279 例(65.2%)患者接受了 NAC,总临床和完全病理缓解率分别为 65.9%和 10.8%。与原发性 RH 患者相比,NAC 患者分期更晚、复发率更高、RH 中位持续时间更长、中位估计出血量更多。调整基线风险因素后,NAC 组和原发性 RH 组之间无无疾病进展或总生存的显著差异。然而,NAC 的应答者具有更好的生存结果。
对于 FIGO 2009 分期 IB2 至 IIB 期的宫颈癌患者,NAC 除了对 NAC 的应答者外,没有手术或生存获益。