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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.

Neoadjuvant platinum-based chemotherapy followed by radical hysterectomy for stage Ib2-IIb adenocarcinoma of the uterine cervix – An Italian multicenter retrospective study

Sartori E.
Writing – Original Draft Preparation
2018-01-01

Abstract

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.
2018
LS4_6 Cancer and its biological basis
ANTICANCER RESEARCH
2-s2.0-85048245970
WOS:000449934200052
Sì, ma tipo non specificato
Inglese
Internazionale
STAMPA
38
6
3627
3634
8
29848719
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. © 2018 International Institute of Anticancer Research. All rights reserved.
Adenocarcinoma of the uterine cervix; cisplatin; neoadjuvant chemotherapy; pattern of recurrence; radical hysterectomy; radiotherapy; Adenocarcinoma; Adult; Aged; Antineoplastic Combined Chemotherapy Protocols; Chemoradiotherapy; Chemotherapy, Adjuvant; Cisplatin; Combined Modality Therapy; Disease-Free Survival; Female; Humans; Hysterectomy; Middle Aged; Neoadjuvant Therapy; Neoplasm Recurrence, Local; Neoplasm Staging; Retrospective Studies; Treatment Outcome; Uterine Cervical Neoplasms; Young Adult
8
info:eu-repo/semantics/article
262
Gadducci, A; Landoni, F; Cosio, S; Zizioli, V; Ferrero, A. M.; Lapresa, M. T.; Maggino, T; Sartori, E.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11379/509686
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