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Obstet Gynecol Sci > Volume 55(12); 2012 > Article
Korean Journal of Obstetrics & Gynecology 2012;55(12):913-919.
DOI: https://doi.org/10.5468/KJOG.2012.55.12.913    Published online December 18, 2012.
Prognosis of stage IIB cervical cancer among treatment regimens: Radical hysterectomy vs. neoadjuvant chemotherapy followed by radical hysterectomy vs. concurrent chemoradiotherapy.
Young Ju Woo, Jung Mi Byun, Dae Hoon Jeong, Young Nam Kim, Su Seon Kim, Young Jin Seo, Moon Su Sung, Kyoung Bok Lee, Ki Tae Kim
1Department of Obstetrics and Gynecology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea.
2Department of Obstetrics and Gynecology, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea. hellojungmi@hanmail.net
3Paik Institute for Clinical Research, Inje University, Busan, Korea.
We aimed to compare the prognosis of patients with stage IIB cervical cancer treated with radical hysterectomy alone, with neoadjuvant chemotherapy followed by radical hysterectomy, and with concurrent chemoradiation therapy (CCRT). METHODS: From January 2000 to December 2006, 104 patients with cervical cancer IIB were diagnosed and managed with radical hysterectomy alone, neoadjuvant chemotherapy followed by radical hysterectomy, and CCRT. The outcomes of patients in terms of the 5-year disease-free survival, overall survival, and recurrence rates were compared. RESULTS: Of 86 eligible patients, 20 were treated with radical hysterectomy alone, 43 with neoadjuvant chemotherapy, and 23 with CCRT. Neoadjuvant chemotherapy with radical hysterectomy was performed in young (P<0.001) and radical hysterectomy alone was performed in the patients with a large tumor size (P<0.001). Among the 3 groups, distant metastasis was the lowest in the neoadjuvant chemotherapy group (p=0.014). Between the neoadjuvant chemotherapy group and radical hysterectomy alone group, radical hysterectomy alone group showed a larger tumor size (>4 cm) (p=0.0459) and more extensive lympho-vascular involvement (p=0.0158) in pathologic finding. CONCLUSION: No significant differences in the 5-year disease-free and overall survival rates were observed among the 3 groups. However, the neoadjuvant chemotherapy group showed lower distant metastasis, smaller tumor size, and less extensive lympho-vascular involvement than the other 2 groups. Accordingly, unnecessary adjuvant therapy could be avoided. These results imply that neoadjuvant chemotherapy could improve the prognosis of patients with cervical cancer IIB.
Key Words: Cervical cancer, Neoadjuvant chemotherapy, Radical hysterectomy, Concurrent chemoradiation therapy, Survival

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