Comparative Analysis Of Neoadjuvant Chemotherapy Plus Surgery Versus Surgery In Stages ?B2??A2 Cervical Cancer

Objectives To compare clinical efficacy of neoadjuvant chemotherapy plus surgery versus surgery in stages IB2? IIA2 cervical cancer.Methods Retrospective analysis of 182 patients with FIGO stage IB2?IIA2 cervical cancer in Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology from May 2010 to December 2012.94 Patients with stage IB2,IIA2 cervical cancer received neoadjuvant chemotherapy(NACT)plus surgery while 88 patients received radical surgery(RS).The response rates(RR)were evaluated and the average survical time,average blood loss,postoperative risk factors,postoperative adjuvant therapy and survival were compared between the two groups.Results The response rate of NACT group was 80.9%,in which 78.2% in patients(FIGO,IB2)and 84.6% in patients(FIGO,IIA2).The average operation time of NACT group was significantly shorter from that of RS group(P=0.020).There was no significant difference in average blood loss between the two groups(P=0.832).Both of the two groups had no positive vaginal margin case.The comparation of cervicl stromal invasion depth,parametrial involvement,lympho-vascular space involvement(LVSI)in two groups were not statistically significant(P>0.05).Compared to RS group,there were no case with cervical canal involvement in NACT group,and the difference was statistically significant(P=0.025).The rate of lymph node metastasis was 16% in NACT group and 28.4% in RS group,and the difference was statistically significant(P=0.043).The rate of postoperative adjuvant treatment in NACT group and RS group were 61.7% and 76.1%,respectivly,and the difference was statistically significant(P=0.036).0ne-year,three-year,five-year disease-free survival(DFS) rates were 93.6%,75.5%,67% in NACT group while that were 89.8%,75%,61.3% in RS group,and there were no statistically significant difference between the two groups(P>0.05).0ne-year,three-year,five-year overall survival(OS)rate of NACT group were 98.9%,91.5%,80.4%,respectively while that of RS group were 98.9% and 87.4%,70.7% respectively and there were no statistically significant difference between the two groups(P > 0.05).Conclusion NACT can effectively control the volume of the tumor,shorten the operation time,reduce the rate of cervical canal involvement,rate of lymph node metastasis and rate of postoperative adjuvant treatment.However,compared with surgery alone,NACT can not improve the patient's DFS and OS.