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European Journal of Gynaecological Oncology (EJGO) is published by IMR Press from Volume 40 Issue 1 (2019). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with S.O.G.
Assessment of primary radical hysterectomy and neoadjuvant chemotherapy followed by radical hysterectomy in Stage IB2, IIA bulky cervical cancer
A. Musaev1, A. B. Guzel1, G. Khatib1,*, U. K. Gulec1, M. A. Vardar1, A. Altıntas Altıntas1, D. Gumurdulu2
1 Department of Obstetrics and Gynecology, Faculty of Medicine, Cukurova University, Adana
2 Department of Pathology, Faculty of Medicine, Cukurova University, Adana (Turkey)
Eur. J. Gynaecol. Oncol. 2015, 36(5), 579–584; https://doi.org/10.12892/ejgo2629.2015
Published: 10 October 2015
Objective: Uncertainty concerning the treatment of Stage IB2-IIA (bulky) cervical cancer is still continuing. In this study, an analysis of Stage IB2-IIA (bulky) cervical cancer was performed. The efficacy of primary radical surgery and neoadjuvant chemotherapy followed by a radical surgery was investigated. Materials and Methods: Medical data of 50 patients who were diagnosed with Stage IB2-IIA (bulky) cervical cancer and treated between 2002-2009 were retrospectively assessed. In the radical surgery group, radical hysterectomy + bilateral pelvic + para-aortic lymphadenectomy were performed. In the neoadjuvant chemotherapy group, a combination of cisplatin/topotecan or paclitaxel/carboplatin was given to the patients and then radical surgery was performed. Each group was evaluated individually. Prognostic factors were determined and survival rates were compared between the groups. A p value was taken < 0.05 for the statistical significance level for all results. Results: Radical surgery after neoadjuvant chemotherapy was performed in 21 and primary radical surgery in 29 patients. Median follow-up time was 36.0 ± 14.0 months. Average of the tumor size before treatment was 50.2 ± 7.6 mm. In the radical surgery after neoadjuvant chemotherapy group, lymphovascular space invasion (LVSI) and tumor size (before and after treatment) were determined to be significant factors for each of disease-free survival (DFS) and overall survival (OS). On multivariate analysis, tumor size (before treatment) was found to be an independent prognostic factor for both of DFS (p = 0.006) and OS (p = 0.010). No significant difference in survival periods was observed among the groups. Conclusion: There was no significant superiority among the two treatment options. Nonetheless, further studies are needed to compare the multimodal approaches in these stages of cervical cancer.
Stage IB2-IIA (bulky) cervical cancer