Analysis Of Clinicopathological Characteristics Of Surgery And Adjuvant Therapy Following Neoadjuvant Chemotherapy In ?B2,?A2 Squamous Carcinoma Of The Uterine Cervix

OBJECTIVE:To explore the prognostic factors in cervical cancer patients received neoadjuvant chemotherapy combined with surgery and post-operative adjuvant therapy.MATERIALS and METHODS:A total of 177 patients with cervical cancer at FIGO ?B2,?A2 who underwent neoadjuvant chemotherapy(NACT)followed by surgery with/without adjuvant therapy in Cancer Hospital Chinese Academy of Medical Science were included.Univariate and multivariate analyses of 5-year overall survival and 5-year disease-free survival were performed.RESULTS:Of 177 patients,133(74.1%)had stage ?B2 and 44(24.9%)had ?A2 cancers.At 59.2months median follow-up,the 5-year disease-free survival was 73.6%and the 5-year overall survival was 86.8%.Univariate analysis revealed that lymph node metastasis,positive margins,deep stromal invasion significantly affected 5-year disease-free survival.Lymph node metastasis,positive margins,deep stromal invasion and tumor size after NACT significantly affected 5-year overall survival.On multivariate analysis,stromal invasion(outer 1/3 or outer 1/2)is independent risk factor of 5-year DFS,and 5-year OS is significantly affected by tumor size>3cm after NACT(p=0.023,OR=3.360,95%Cl 1.183-9.539)and positive margins(p=0.007,OR=24.21,95%CI 2.410-243.4).CONCLUSION:The only independent risk factor for 5-year DFS in patients received NACT and hysterectomy is deep stromal invasion of the cervix.The presence of tumor size>3cm after NACT adversely affect 5-year OS.