An Analysis Of Neoadjuvant Chemotherapy Followed By Radical Surgery In Locally Bulky Cervical Carcinoma

Object To evaluate the effect of neoadjuvant chemotherapy followed by radicalsurgery in patients with locally bulky cervical carcinoma stages ⅠB2 and ⅡA.Method Between September 2003 and February 2004 , 51 untreated patientswith cervical carcinoma Ⅰ B2 and Ⅱ A ,as study group, were givenneoadjuvant chemotherapy with cisplatin, vincristine and bleomylin for onecycle followed by radical hysterectomy and pelvic lymphadenectomy; 51patients as control group were directly treated with radical surgery .The tumorsize, depth of stromal invasion, lymph node metastasis and involvement ofsurgical specimens were assessed after operation between the two groups.Result The overall clinical response rate was 41.2%. There were no completeand progressive ones. The blood loss during operation was 116.82±45.50ml,itwas significantly lower than that in control group( P<0.01).The lymph nodemetastasis rate of the two groups were 21.57% and 43.14%(P<0.05). The ratioof both deep stromal invasion (25.49%) and lymphovascular permeation(9.80%)in study group were lower than those in control group ( 47.06%,31.37%respectively) (P<0.05).Conclusion Preoperative neoadjuvant chemotherapy can decrease theprimary tumor size and benefit the following radical surgery ,lower the lymphnode metastasis rate and deep stromal invasion rate without increasing theoperative complications.