The Efficacy of Neoadjuvant Paclitaxel-Carboplatin Chemotherapy Followed by Radical Hysterectomy Compared to Radical Hysterectomy alone in Bulky Stage IB2-IIA Cervical Cancer
Nisa Prueksaritanond MD*, Parichat Chaisarn MD**, Marut Yanaranop MD*
Affiliation : * Department of Obstetrics and Gynecology, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, Thailand ** Department of Obstetrics and Gynecology, Rajavithi Hospital, Bangkok, Thailand
Objective : To compare the efficacy of neoadjuvant paclitaxel-carboplatin chemotherapy followed by radical hysterectomy with
radical hysterectomy alone in patients with bulky cervical cancer stage IB2-IIA.
Material and Method: From January 2000 through December 2009, 80 patients with bulky cervical cancer stage IB2-IIA
that received neoadjuvant paclitaxel-carboplatin chemotherapy (n = 40) or immediate primary surgery (n = 40) were
reviewed. The efficacy of neoadjuvant chemotherapy on the basis of feasibility in operation and pathological prognostic
factors and the percentage of patients who needed postoperative adjuvant concurrent chemoradiation therapy were compared.
Results : There were no significant differences between group in age, tumor size, FIGO staging, histologic type and grading
at the time of diagnosis. All patients in neoadjuvant chemotherapy group successfully underwent radical hysterectomy. The
pathological findings included tumor size, deep cervical invasion, parametrial involvement, positive surgical margin and
lymphovascular space invasion were statistically significant decrease in neoadjuvant chemotherapy group. Nevertheless, the
pelvic nodal metastasis was not different between both groups. Adjuvant concurrent chemoradiation therapy had a statistically
significant decrease in the neoadjuvant chemotherapy group.
Conclusion : Neoadjuvant chemotherapy significant by improves the feasibility in operation and the pathological prognostic
factors, and decreases the percentage of patients who needed postoperative adjuvant concurrent chemoradiation therapy.
Keywords : Bulky cervical cancer stage IB2-IIA, Neoadjuvant chemotherapy, Radical hysterectomy, Rajavithi Hospital
