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Analysis of prognostic factors for patients with bulky squamous cell carcinoma of the uterine cervix who underwent neoadjuvant chemotherapy followed by radical hysterectomy

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Abstract

Background

Neoadjuvant chemotherapy (NAC) is not yet widely recommended for the treatment of stage I/II cervical cancer. However, it may be possible to achieve a favorable outcome by selecting appropriate patients. In the present study, prognostic factors were retrospectively investigated to obtain data for devising individualized NAC.

Patients and methods

The subjects were 33 patients with bulky stage Ib2–IIb squamous cell carcinoma (SCC) of the uterine cervix who gave consent and were scheduled to undergo radical hysterectomy. The patients intravenously received irinotecan 70 mg/m2 on days 1 and 8 and cisplatin 70 mg/m2 on day 1 of a 21-day course, and two courses were performed in principle. The potential prognostic factors investigated were age, performance status (PS), clinical stage, lymph node metastasis and tumor size before NAC, SCC antigen value, anti-tumor response, histological effect of NAC, lymph node metastasis in resected specimens, and postoperative adjuvant therapy after NAC. The impacts of these factors on overall survival (OS) were calculated with the Cox regression model.

Results

According to the univariate analysis, lymph node metastasis before NAC, SCC antigen value after NAC, anti-tumor response, and histological effect of NAC significantly influenced OS. These factors were tested in a multivariate model, and significant prognostic factors were lymph node metastasis before NAC (hazard ratio 0.116, P = 0.027) and anti-tumor response (hazard ratio 0.025, P = 0.003).

Conclusion

The presence or absence of lymph node metastasis by computed tomography imaging was the only significant prognostic factor identified during the pre-NAC period.

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, 020-8505, Japan

    Eriko Takatori, Tadahiro Shoji, Hideo Omi, Masahiro Kagabu, Fumiharu Miura, Satoshi Takeuchi & Toru Sugiyama

  2. Department of Obstetrics and Gynecology, National Hospital Organization Kokura Medical Center, Kokura, Japan

    Seisuke Kumagai

  3. Department of Gynecology, Miyama Hospital, Oshu, Japan

    Akira Yoshizaki

  4. Department of Gynecology, Medical Coat Hachinohe West Hospital, Hachinohe, Japan

    Akira Sato

Authors
  1. Eriko Takatori
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  2. Tadahiro Shoji
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  3. Hideo Omi
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  4. Masahiro Kagabu
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  5. Fumiharu Miura
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  6. Satoshi Takeuchi
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  7. Seisuke Kumagai
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  8. Akira Yoshizaki
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  9. Akira Sato
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  10. Toru Sugiyama
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Corresponding author

Correspondence to Tadahiro Shoji.

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Takatori, E., Shoji, T., Omi, H. et al. Analysis of prognostic factors for patients with bulky squamous cell carcinoma of the uterine cervix who underwent neoadjuvant chemotherapy followed by radical hysterectomy. Int J Clin Oncol 20, 345–350 (2015). https://doi.org/10.1007/s10147-014-0702-6

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  • DOI: https://doi.org/10.1007/s10147-014-0702-6

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