Clinical results and prognostic factors of patients with locally advanced cervical carcinoma treated with neoadjuvant therapy followed by radical hysterectomy : a retrospective study of 182 patients / 中华放射肿瘤学杂志

ABSTRACT

Objective To analyze the clinical outcome and prognostic factors of concurrent radiochemotherapy (CRCT) or radiotherapy (RT) alone followed by radical hysterectomy in cervical cancer.MethodsBetween April 2006 and June 2011,182 patients with FIGO ⅠB2-ⅢB cervical carcinoma were treated with preoperative CRCT ( 123 patients) or RT alone ( 59 patients) followed by radical surgery.Weekly cisplatin (40 mg/m2)were administered during radiotherapy for patients treated with CRCT.Preoperative RT doses were 40-50 Gy in 20-25 fractions.Total hysterosalpingo-oophorectomy and pelvic lymph node dissection was performed 2-3 weeks after neoadjuvant therapy.The prognostic factors were analyzed by Cox-regression method.ResultsSixty-nine patients were followed up for 3 years.For patients with tumor ≥4.5 cm,there were no significant differences in the 3-year progression-free survival (PFS) and overall survival (OS) rates between CRCT and RT alone ( x2 =1.84 and 1.56,P =0.176 and 0.221 ).For patients with tumor ＜ 4.5 cm,CRCT group had higher PFS and OS rates than RT alone ( x2 =5.22 and 4.81,P=0.022 and 0.018).The 3-year PFS and OS rates were 92.0％ and 93.8％.By multivariate analysis,tumor diameter ( ≥6 cm vs.＜ 6 cm) was significant prognostic factor for PFS and OS (x2 =2.56,P =0.011 ;x2 =4.06,P =0.007 ),age ( ＜ 48 vs.≥ 48 years) was significant prognostic factor for OS (x2=4.86,P =0.046),and postoperative lymph node status (positive vs.negative) was significant prognostic factor for PFS ( x2 =1.04,P =0.010).ConclusionsTreatment with CRCT or RT followed by radical surgery has achieved good OS and PFS for patients with FIGOⅠB2-ⅢB cervical cancer.Tumor diameter,age and postoperative lymph node status are important prognostic factors for survival.