Neoadjuvant Chemotherapy Followed by Radical Surgery in Patients Affected by FIGO Stage IVA Cervical Cancer |
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Authors: | Pierluigi Benedetti Panici Filippo Bellati Natalina Manci Milena Pernice Francesco Plotti Violante Di Donato Marco Calcagno Marzio Angelo Zullo Ludovico Muzii Roberto Angioli |
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Institution: | (1) Department of Obstetrics and Gynecology, University of Rome “La Sapienza”, Viale del Policlinico, 155 Rome, Italy;(2) Departments of Obstetrics and Gynecology, University Campus Bio-Medico of Rome, Rome, Italy |
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Abstract: | Background Concomitant chemoradiotherapy represents the standard treatment for patients affected by locally advanced cervical cancer.
Survival rates in patients affected by FIGO stage IVA disease remain poor. Some authors have suggested that neoadjuvant chemotherapy
followed by radical surgery might be a valid alternative to standard treatment. The objective of this study was to analyze
the feasibility and results obtained by neoadjuvant chemotherapy in patients affected by stage IVA disease.
Methods Eighteen patients affected by FIGO stage IVA cervical cancer were treated with 175 mg/m2 paclitaxel and 75 mg/m2 cisplatin every 21 days for three courses followed by radical surgery when feasible.
Results All patients were subjected to the three planned chemotherapy courses. Two patients achieved a complete clinical response,
and 10 patients achieved a partial clinical response. Ten patients were subjected to anterior pelvic exenteration, whereas
the remaining eight patients were treated with chemotherapy, radiotherapy, and concomitant chemoradiotherapy. The estimated
3-year and 5-year overall survival rates were 47.4% and 31.6%, respectively. Patients eligible for surgery benefited from
significantly longer survival rates.
Conclusions Neoadjuvant chemotherapy followed by radical surgery is feasible in approximately half of patients affected by FIGO stage
IVA cervical cancer. Overall survival rates appear similar to those reported with concomitant chemoradiotherapy. Patients
who are amenable to radical surgery after chemotherapy may benefit from long-term survival rates. |
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Keywords: | Anterior pelvic exenteration Cervical cancer Neoadjuvant chemotherapy Radical surgery |
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