Outcome of patients with bulky IB (≥ 6 cm) cervical squamous cell carcinoma with and without cisplatin-based neoadjuvant chemotherapy

Peng Hui Wang, Yen Hou Chang, Ying Hui Yang, Wen Hsun Chang, Shu Yun Huang, Chiung Ru Lai, Chi Mou Juang, Yi Jen Chen, Huann Cheng Horng, Kuo Chang Wen, Heung Tat Ng, Chiou Chung Yuan, Kuan Chong Chao, Ming Shyen Yen

Research output: Contribution to journalArticle

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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 languageEnglish
Pages (from-to)330-336
Number of pages7
JournalTaiwanese Journal of Obstetrics and Gynecology
Volume53
Issue number3
DOIs
Publication statusPublished - Sep 1 2014

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Hysterectomy
Cisplatin
Squamous Cell Carcinoma
Drug Therapy
Confidence Intervals
Neoplasms
Gynecology
Obstetrics
Multivariate Analysis
Retrospective Studies
Lymph Nodes
Neoplasm Metastasis
Morbidity
Survival

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 journalArticle

Wang, PH, Chang, YH, Yang, YH, Chang, WH, Huang, SY, Lai, CR, Juang, CM, Chen, YJ, Horng, HC, Wen, KC, Ng, HT, Yuan, CC, Chao, KC & Yen, MS 2014, 'Outcome of patients with bulky IB (≥ 6 cm) cervical squamous cell carcinoma with and without cisplatin-based neoadjuvant chemotherapy', Taiwanese Journal of Obstetrics and Gynecology, vol. 53, no. 3, pp. 330-336. https://doi.org/10.1016/j.tjog.2014.05.001
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. / Outcome of patients with bulky IB (≥ 6 cm) cervical squamous cell carcinoma with and without cisplatin-based neoadjuvant chemotherapy. In: Taiwanese Journal of Obstetrics and Gynecology. 2014 ; Vol. 53, No. 3. pp. 330-336.
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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.",
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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

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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

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