Neoadjuvant Platinum-based Chemotherapy Followed by Radical Hysterectomy for Stage Ib2-IIb Adenocarcinoma of the Uterine Cervix - An Italian Multicenter Retrospective Study
| Autor: | Enrico Sartori, Stefania Cosio, Angiolo Gadducci, Tiziano Maggino, Valentina Zizioli, Paolo Zola, Anna Maria Ferrero, Maria Teresa Lapresa, Fabio Landoni |
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| Přispěvatelé: | Gadducci, A, Landoni, F, Cosio, S, Zizioli, V, Zola, P, Ferrero, A, Lapresa, M, Maggino, T, Sartori, E |
| Rok vydání: | 2018 |
| Předmět: |
0301 basic medicine
Uterine Cervical Neoplasm Cancer Research medicine.medical_treatment Uterine Cervical Neoplasms Gastroenterology 0302 clinical medicine Retrospective Studie Adenocarcinoma of the uterine cervix Antineoplastic Combined Chemotherapy Protocols Radical hysterectomy Stage (cooking) Adjuvant Neoadjuvant therapy Cisplatin Neoadjuvant chemotherapy Pattern of recurrence Radiotherapy Adenocarcinoma Adult Aged Chemoradiotherapy Chemotherapy Adjuvant Combined Modality Therapy Disease-Free Survival Female Humans Hysterectomy Middle Aged Neoadjuvant Therapy Neoplasm Recurrence Local Neoplasm Staging Retrospective Studies Treatment Outcome Young Adult Oncology General Medicine Local 030220 oncology & carcinogenesis Human medicine.medical_specialty 03 medical and health sciences cisplatin neoadjuvant chemotherapy pattern of recurrence radical hysterectomy radiotherapy Internal medicine medicine Chemotherapy Radical Hysterectomy Antineoplastic Combined Chemotherapy Protocol business.industry Retrospective cohort study medicine.disease Radiation therapy Neoplasm Recurrence 030104 developmental biology business |
| Zdroj: | Anticancer research. 38(6) |
| ISSN: | 1791-7530 |
| Popis: | Aim To assess the patterns of recurrence and clinical outcomes of patients with cervical adenocarcinoma who underwent neoadjuvant platinum-based chemotherapy (NACT) followed by radical hysterectomy. Patients and methods Data were retrospectively analyzed for 82 patients with International Federation of Gynecology and Obstetrics stage Ib2-IIb cervical adenocarcinoma who underwent this chemo-surgical treatment. The median follow-up of survivors was 89 months (range=5-208 months). Results Pathological complete response, optimal response and suboptimal response with intra-cervical residual disease were obtained in five (6%), 10 (12%) and 36 (44%) patients, respectively. Adjuvant external-beam radiotherapy with or without concurrent chemotherapy was administered to 47 patients. Nineteen (23%) out of the 82 patients experienced recurrence after a median of 12 months (range=5.3-86.8 months). Recurrent disease was pelvic in 12 (63%) patients, extra-pelvic in five (26%), and both pelvic and extra-pelvic in two (10%). According to pathological response, tumor relapsed in 10% of optimal responders, 14% of sub-optimal responders with intra-cervical residual disease, and 36% of sub-optimal responders with extra-cervical residual disease or non-responders. Five-year recurrence-free and overall survival were 77% and 84%, respectively. Patients who achieved an optimal response or sub-optimal response with intra-cervical residual disease had better 5-year recurrence-free (87% vs. 64%, p=0.017) and overall (92% vs. 74%, p=0.012) survival than those who had sub-optimal response with extra-cervical residual disease or no response. The latter had a 1.441-fold higher risk of recurrence and a 1.652-fold higher risk of death than those who obtained an optimal response or a sub-optimal response with intra-cervical residual disease. Conclusion NACT followed by radical hysterectomy may be an option for patients with stage Ib2-IIb adenocarcinoma of the uterine cervix. |
| Databáze: | OpenAIRE |
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