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Neoadjuvant Chemotherapy Followed by Surgery in Figo Stage IB2, IIA2, and IIB Cervical Cancer—Survival Analysis

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Indian Journal of Gynecologic Oncology Aims and scope Submit manuscript

Abstract

Purpose

Early-stage bulky cancers of the cervix and locally advanced cancer (defined as FIGO 2009 Stages IB2, IIA2 and IIB) form a distinctive subset of “curable” cervical cancers with good 5-year survival rates. The use of neoadjuvant chemotherapy followed by radical hysterectomy has been considered an attractive approach to improve disease control and reduce toxicity associated with radiation. In view of economic implications, availability of radiotherapy centres and radiotherapy induced morbidity, the advantages of downsizing the disease without the use of radiation are tempting and open a completely new philosophy of radical treatment for locally advanced cervical cancer. This study was conducted to establish non-inferiority of neoadjuvant chemotherapy in carcinoma cervix with concurrent chemoradiation in terms of disease-free survival and overall survival and to assess the pathological response and chances of avoiding radiation and its associated morbidity.

Methods

Our study retrospectively reviewed clinical results of patients with cervical cancer staged IB2, IIA2, and IIB according to the 2009 FIGO classification treated with neoadjuvant chemotherapy followed by radical hysterectomy.

Results

Survival following neoadjuvant chemotherapy and radical surgery was found to be less in comparison with standard survival rates in IB2, IIA2, and IIB (FIGO 2009) cervical cancer.

Conclusion

Therapeutic efficacy of NACT should be viewed with caution since more than one-third of patients were treated with adjuvant brachytherapy. However, in developing countries with higher incidence of cervical cancers wherein brachytherapy resources are scarce, it is still open for debate and discussion.

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Authors and Affiliations

  1. Department of Surgical Oncology, Government Royapettah Hospital, 1, Westcott Road, Royapettah, Chennai, Tamil Nadu, 600014, India

    Subbiah Shanmugam, Sujay Susikar & R. R. Pravenkumar

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  1. Subbiah Shanmugam
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  2. Sujay Susikar
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  3. R. R. Pravenkumar
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Correspondence to Subbiah Shanmugam.

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Shanmugam, S., Susikar, S. & Pravenkumar, R.R. Neoadjuvant Chemotherapy Followed by Surgery in Figo Stage IB2, IIA2, and IIB Cervical Cancer—Survival Analysis. Indian J Gynecol Oncolog 21, 56 (2023). https://doi.org/10.1007/s40944-023-00738-0

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