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Multicenter Study
. 2024 Jun 22;24(1):365.
doi: 10.1186/s12905-024-03215-8.

The role of neoadjuvant chemotherapy before radical surgery in stage IB2/IIA2 squamous cell cervical cancers

Aysun Alci  1 , Okan Aytekin  2 , Burak Ersak  2 , Fatih Kilic  2 , Okan Oktar  3 , Cakır Caner  3 , Vakkas Korkmaz  2 , Gunsu Kimyon Comert  2 , İlker Selcuk  2 , Tayfun Toptas  4 , Nurettin Boran  3 , Tolga Tasci  5 , Alper Karalok  6 , Derman Basaran  7 , Ozlem Moraloglu Tekin  2 , Yaprak Engin Ustun  3 , Taner Turan  2 , Isin Ureyen  4
Affiliations
Multicenter Study

The role of neoadjuvant chemotherapy before radical surgery in stage IB2/IIA2 squamous cell cervical cancers

Aysun Alci et al. BMC Womens Health. .

Abstract

Background: This study aimed to evaluate the outcomes of patients diagnosed with stage IB2/IIA2 cervical squamous cell carcinoma who underwent neoadjuvant chemotherapy (NACT) prior to radical hysterectomy compared to those who did not receive NACT before surgery.

Materials and methods: This is a multicenter study including data of 6 gynecological oncology departments. The study is approved from one of the institution's local ethics committee. Patients were stratified into two cohorts based on the receipt of NACT preceding their surgical intervention. Clinico-pathological factors and progression-free survival were analyzed.

Results: Totally 87 patients were included. Lymphovascular space invasion (LVSI) was observed as 40% in the group receiving NACT, while it was 66.1% in the group not receiving NACT (p = 0.036). Deep stromal invasion (> 50%) was 56% in the group receiving NACT and 84.8% in the group not receiving NACT (p = 0.001). In the univariate analysis, application of NACT is statistically significant among the factors that would be associated with disease-free survival. Consequently, a multivariate analysis was conducted for progression-free survival, incorporating factors such as the depth of stromal invasion, the presence of LVSI, and the administration of NACT. Of these, only the administration of NACT emerged as an independent predictor associated with decreased progression-free survival. (RR:5.88; 95% CI: 1.63-21.25; p = 0.07).

Conclusions: NACT shouldn't be used routinely in patients with stage IB2/IIA2 cervical cancer before radical surgery. Presented as oral presentation at National Congress of Gynaecological Oncology & National Congress of Cervical Pathologies and Colposcopy (2022/ TURKEY).

Keywords: Cervical cancer; Neoadjuvant chemotherapy; Radical surgery.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Fig. 1
Fig. 1
Study flow diagram. RS: Radical surgery NACT: neoadjuvant chemotherapy 5 FU: 5 fluorouracil, UFT: Tegafur and uracil
See this image and copyright information in PMC

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