Abstract
Objective: To study the surgical morbidity and outcomes of patients with markedly bulky cervical squamous cell carcinoma (≥ 6cm Cx-SCC) who underwent radical hysterectomy (RH) with and without neoadjuvant chemotherapy (NACT). Materials and methods: This retrospective study enrolled patients with International Federation of Gynecology and Obstetrics (FIGO) IB markedly bulky Cx-SCC who were treated with either three courses of weekly single agent cisplatin NACT (50mg/m2) and subsequent radical hysterectomy (NACT-RH) or direct radical hysterectomy (RH) between 1996 and 2001. A total of 60 patients fulfilled the criteria, including 35 and 25 patients with NsACT-RH and RH, respectively. Results: There was no statistically significant difference in basic characteristics between the two groups, except the smaller pathological tumor size, less blood loss, and lower immediate complication rate in the NACT-RH group. Median survival was 143.8months in the NACT-RH group and 129.8months in the RH group, respectively, without a statistically significant difference. Multivariate analysis showed that large pathological tumor size [hazard ratio (HR) 10.66, 95% confidence interval (CI) 2.93-38.80], the presence of para-aortic lymph node metastases and an immediate complication (HR 8.33 and 4.55, 95% CI 1.66-41.75 and 1.35-15.27, respectively) contributed to a worse outcome. Conclusion: Weekly single agent cisplatin NACT indeed reduced the pathological tumor size and immediate complication rate during the RH, supporting the feasibility of subsequent RH in the management of patients with bulky Cx-SCC.
| Original language | English |
|---|---|
| Pages (from-to) | 330-336 |
| Number of pages | 7 |
| Journal | Taiwanese Journal of Obstetrics and Gynecology |
| Volume | 53 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - Sep 1 2014 |
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Keywords
- Bulky cervical squamous cell carcinoma
- Cervical cancer
- Neoadjuvant chemotherapy
- Radical hysterectomy
ASJC Scopus subject areas
- Obstetrics and Gynaecology
- Medicine(all)
Cite this
Outcome of patients with bulky IB (≥ 6 cm) cervical squamous cell carcinoma with and without cisplatin-based neoadjuvant chemotherapy. / Wang, Peng Hui; Chang, Yen Hou; Yang, Ying Hui; Chang, Wen Hsun; Huang, Shu Yun; Lai, Chiung Ru; Juang, Chi Mou; Chen, Yi Jen; Horng, Huann Cheng; Wen, Kuo Chang; Ng, Heung Tat; Yuan, Chiou Chung; Chao, Kuan Chong; Yen, Ming Shyen.
In: Taiwanese Journal of Obstetrics and Gynecology, Vol. 53, No. 3, 01.09.2014, p. 330-336.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Outcome of patients with bulky IB (≥ 6 cm) cervical squamous cell carcinoma with and without cisplatin-based neoadjuvant chemotherapy
AU - Wang, Peng Hui
AU - Chang, Yen Hou
AU - Yang, Ying Hui
AU - Chang, Wen Hsun
AU - Huang, Shu Yun
AU - Lai, Chiung Ru
AU - Juang, Chi Mou
AU - Chen, Yi Jen
AU - Horng, Huann Cheng
AU - Wen, Kuo Chang
AU - Ng, Heung Tat
AU - Yuan, Chiou Chung
AU - Chao, Kuan Chong
AU - Yen, Ming Shyen
PY - 2014/9/1
Y1 - 2014/9/1
N2 - Objective: To study the surgical morbidity and outcomes of patients with markedly bulky cervical squamous cell carcinoma (≥ 6cm Cx-SCC) who underwent radical hysterectomy (RH) with and without neoadjuvant chemotherapy (NACT). Materials and methods: This retrospective study enrolled patients with International Federation of Gynecology and Obstetrics (FIGO) IB markedly bulky Cx-SCC who were treated with either three courses of weekly single agent cisplatin NACT (50mg/m2) and subsequent radical hysterectomy (NACT-RH) or direct radical hysterectomy (RH) between 1996 and 2001. A total of 60 patients fulfilled the criteria, including 35 and 25 patients with NsACT-RH and RH, respectively. Results: There was no statistically significant difference in basic characteristics between the two groups, except the smaller pathological tumor size, less blood loss, and lower immediate complication rate in the NACT-RH group. Median survival was 143.8months in the NACT-RH group and 129.8months in the RH group, respectively, without a statistically significant difference. Multivariate analysis showed that large pathological tumor size [hazard ratio (HR) 10.66, 95% confidence interval (CI) 2.93-38.80], the presence of para-aortic lymph node metastases and an immediate complication (HR 8.33 and 4.55, 95% CI 1.66-41.75 and 1.35-15.27, respectively) contributed to a worse outcome. Conclusion: Weekly single agent cisplatin NACT indeed reduced the pathological tumor size and immediate complication rate during the RH, supporting the feasibility of subsequent RH in the management of patients with bulky Cx-SCC.
AB - Objective: To study the surgical morbidity and outcomes of patients with markedly bulky cervical squamous cell carcinoma (≥ 6cm Cx-SCC) who underwent radical hysterectomy (RH) with and without neoadjuvant chemotherapy (NACT). Materials and methods: This retrospective study enrolled patients with International Federation of Gynecology and Obstetrics (FIGO) IB markedly bulky Cx-SCC who were treated with either three courses of weekly single agent cisplatin NACT (50mg/m2) and subsequent radical hysterectomy (NACT-RH) or direct radical hysterectomy (RH) between 1996 and 2001. A total of 60 patients fulfilled the criteria, including 35 and 25 patients with NsACT-RH and RH, respectively. Results: There was no statistically significant difference in basic characteristics between the two groups, except the smaller pathological tumor size, less blood loss, and lower immediate complication rate in the NACT-RH group. Median survival was 143.8months in the NACT-RH group and 129.8months in the RH group, respectively, without a statistically significant difference. Multivariate analysis showed that large pathological tumor size [hazard ratio (HR) 10.66, 95% confidence interval (CI) 2.93-38.80], the presence of para-aortic lymph node metastases and an immediate complication (HR 8.33 and 4.55, 95% CI 1.66-41.75 and 1.35-15.27, respectively) contributed to a worse outcome. Conclusion: Weekly single agent cisplatin NACT indeed reduced the pathological tumor size and immediate complication rate during the RH, supporting the feasibility of subsequent RH in the management of patients with bulky Cx-SCC.
KW - Bulky cervical squamous cell carcinoma
KW - Cervical cancer
KW - Neoadjuvant chemotherapy
KW - Radical hysterectomy
UR - http://www.scopus.com/inward/record.url?scp=84907538899&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84907538899&partnerID=8YFLogxK
U2 - 10.1016/j.tjog.2014.05.001
DO - 10.1016/j.tjog.2014.05.001
M3 - Article
VL - 53
SP - 330
EP - 336
JO - Taiwanese Journal of Obstetrics and Gynecology
JF - Taiwanese Journal of Obstetrics and Gynecology
SN - 1028-4559
IS - 3
ER -