Views: 1,479 | Downloads:
21
| Responses: 0
| XML | Respond to this article | Alert & updates | Request permissions | Email to a friend |
Original ArticleOpen Access
Comparative Study of Bulky Stage IB and IIA Cervical Cancer Patients Treated by Radical Hysterectomy with and without Neoadjuvant Chemotherapy : Long-Term Follow-up
Manusirivithaya S 
,
lsariyodom P ,
Chareoniam V ,
Srisomboon J ,
Pantusart A
,
lsariyodom P ,
Chareoniam V ,
Srisomboon J ,
Pantusart A PA WARES ISARIYODOM, M.D.**,
JATUPOL SRISOMBOON, M.D.***,
One hundred and ninety patients with bulky (> 3 em) stage IB and IIA cervical cancer
who underwent radical hysterectomy between 1991 and 1994 at Maharaj Nakorn Chiang Mai Hos-
pital were reviewed to determine whether neoadjuvant chemotherapy (NAC) with MY AC (Metho-
trexate, Vinblastine, Adriamycin, Cisplatin) improved survival. There were 42 patients treated with
pre-operataive NAC (MVAC 1-3 courses) and 148 patients treated by primary surgery (PS). In
the NAC group, the overall response rate from MVAC was 88.1 per cent with 31.0 per cent
having complete clinical response and 7.1 per cent with complete pathological response. Pelvic
lymph node metastasis was not significantly different between the NAC group (16.7%) and the
PS group (18.2%). At a median follow-up of 64.5 months, 19.0 per cent in the NAC group and
18.2 per cent in the PS group had tumor recurrence. The 5-year progression free and overall sur-
vival was 80.8 per cent and 92.0 per cent respectively for the NAC group which was not signifi-
cantly different from 80.2 per cent and 92.9 per cent respectively in the PS group. In conclusion,
although NAC can decrease the tumor size and produce a high response rate, it does not improve
survival in bulky stage IB and IIA cervical cancer patients.
Key word
: Chemotherapy, Cervical Cancer, Survival
JATUPOL SRISOMBOON, M.D.***,
One hundred and ninety patients with bulky (> 3 em) stage IB and IIA cervical cancer
who underwent radical hysterectomy between 1991 and 1994 at Maharaj Nakorn Chiang Mai Hos-
pital were reviewed to determine whether neoadjuvant chemotherapy (NAC) with MY AC (Metho-
trexate, Vinblastine, Adriamycin, Cisplatin) improved survival. There were 42 patients treated with
pre-operataive NAC (MVAC 1-3 courses) and 148 patients treated by primary surgery (PS). In
the NAC group, the overall response rate from MVAC was 88.1 per cent with 31.0 per cent
having complete clinical response and 7.1 per cent with complete pathological response. Pelvic
lymph node metastasis was not significantly different between the NAC group (16.7%) and the
PS group (18.2%). At a median follow-up of 64.5 months, 19.0 per cent in the NAC group and
18.2 per cent in the PS group had tumor recurrence. The 5-year progression free and overall sur-
vival was 80.8 per cent and 92.0 per cent respectively for the NAC group which was not signifi-
cantly different from 80.2 per cent and 92.9 per cent respectively in the PS group. In conclusion,
although NAC can decrease the tumor size and produce a high response rate, it does not improve
survival in bulky stage IB and IIA cervical cancer patients.
Key word
: Chemotherapy, Cervical Cancer, Survival
Download:
PDF