Treatment of stage IB2, IIA bulky cervical cancer: A single-institution experience of neoadjuvant chemotherapy followed by radical hysterectomy and primary radical hysterectomy

Introduction The aim of this study was to compare the efficacy and safety of neoadjuvant chemotherapy (NAC) followed by radical hysterectomy (NAC group) with primary radical hysterectomy (RH group). Methods We reviewed all patients with bulky stage IB-IIA cervical cancer treated at Seoul National University Hospital from January 1, 2000 to December 31, 2006. Thirty-three patients were treated with NAC prior to radical hysterectomy, and 41 patients were treated with radical hysterectomy. Results Clinical characteristics were not significantly different between the two groups. The response rate in the NAC group was 81.8%. Operation time, estimated blood loss, and complication rate were not significantly different between the two groups. Pathologic outcomes were improved in the NAC group. Adjuvant therapy was less frequently performed in the NAC group (51.6%) than in the RH group (82.9%) (P = 0.005). The 5-year progressionfree survival was 90.7% in the NAC group and 81.3% in the RH group, but the difference was not statistically significant (P = 0.297). Conclusion The results of this study suggest that NAC may improve pathologic outcomes, decrease the need for adjuvant radiation therapy and have a comparable operation feasibility without affecting progression-free survival.