| Objective To investigate the efficiency of neoadjuvant chemotherapy (NACT)upon pelvic node metastasis and survival in patients with early stage bulky cervical cancer.Methods A retrospective review of 165 patients with stageâ… b2 andâ…¡a2 cervical cancer with bulky lesions in our hospital was performed. Two groups were made according to chemotherapy or not:68 cases with NACT before operation and 97 cases with primary surgery. Rates of lymph node metastasis were compared, the value of lower pelvic nodes(LPN) on predicting upper pelvic nodes(UPN) was assessed, and their survival was analyzed through follow-up data.Result A total of 165 patients were included in the analysis. The total response rate to NACT was 62%(42/68),with lower incidence of pelvic node involvement (17/1387,1.2%)than primary surgery group(56/1970,2.8%),p=0.002. LPN can predict the status of UPN, positive predict value(PPV) is 100% and negative predict value(NPV) is 0 in the NACT group, 97.6% and 28.6% in the primary surgery group, respectively. The 5 year survival in patients with positive lymph nodes is lower than those without (81% vs 90%, p=0.326); is higher in patients with NACT than in initial surgery arm (94% vs 83%, p=0.199); and is higher in patients who responded well compared with non-responsers ( 100% vs 84%, p=0.057).Conclusion NACT might be helpful in controlling pelvic node metastasis,and thus in increasing 5 year survival and the overall survival on chemotherapy responsers in patients with early stage bulky cervical cancer. |
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