| Objectives: The aim of this study was to investigate the effect of neoadjuvant chemotherapy (NACT) on survival of patients who underwent radical surgery and to analysis the relationships between response to NACT and risk factors.Methods: From January 02 to December 08, 3896 patients with stage IB/IIB or stageâ…¡B cervical carcinoma were reviewed, 1018 receiving NACT (the NACT group) and 2538 undergoing radical surgery (the surgery/control group). Matched case-control comparison was used in this study, 707 patients received NACT while 707 patients were treated with PST directly. The clinical and pathological responses, lymph node metastasis, parametrial involvement, toxicity, 3-year disease-free survival (DFS) and overall survival (OS), and the relation between responses to NACT and long-term survival were investigated.Results: The percentage of stageâ…¡B and the mean tumor size were no significant for the NACT group than the surgery group. Clinical objective response (CR + PR) was recorded in 584 patients (82.6%), 85 CRs and 499 PRs. 33 with pathological complete response, 22 with carcinoma in situ, and 50 with stroma infiltrated 1-3mm. Incidence of deep stromal invasion and LVSI in NACT group were lower than that in the control arm in stageâ… B1-â…¡A (p<0.05, p<0.05), and also did it in stageâ…¡B . In FIGO stageâ… B-â…¡B, the 5-year DFS and OS in NACT group were higher than those in surgery group. According to clinical and pathological responses, we divided all patients in NACT group into three subgroups: high/intermediate/poor response subgroups, we found out that better clinical/pathological responses were favorably =associated with both disease-free survival and overall survival.Conclusion: NACT improved long-term DFS and OS of patients with stage IB/IIA or stageâ…¡B cervical carcinoma. Better responses to NACT were associated with more survival benefits. |
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