The Risk Factor for Recurrence after Neoadjuvant Chemotherapy and Radical Hysterectomy in Cervical cancer

Kim, Seung Ryong; Lee, Jung Han; Hwang, Jung Hye; Moon, Young Jin; Kim, Kyung Tae; Cho, Sam Hyun; Moon, Hyung; Hwang, Youn Yeoung

Abstract

OBJECTIVE
This study was done to assess long-term survival and risk factors for recurrence after neoadjuvant chemotherapy and radical hysterectomy for locally advanced cervical cancer patients.
METHODS
Between August 19S3 and May 1990, 80 cervical cancer stage IB-IIB patients with tumor diameter 4cm or more received neoadjuvant VBP chemotherapy and radical hysterectomy. After follow-up more than 10 years for these patients, survival rate and risk factors for recurrence were analyzed.
RESULTS
Seventy eight of SO patients were followed for 10 years. During this period, 20,5% patients(16/78) had recurrences and all of them died of recurrence. Five and 10 year survival rates were 82%(64/78) and 79.4%(62/78), respectively. High risk factor for recurrence was pelvic lymph node invasion. However, clinical stage, initial tumor mass size, number of neoadjuvant chemotherapy, clinical response, or residual tumor size were not clinically significant risk factors for recurrence. Initial tumor size was correlated with pelvic lymph node metastasis. In recurrent patients, site of recurrence was not different according to pelvic lymph node status. For node positive patients, combination of chemotherapy and radiation seemed to be more effective in reducing recurrence compared to chemotherapy or radiation only.
CONCLUSION
For locally advanced stage IB-IIB cervical cancer patients who received neoadjuvani chemotherapy and radical hysterectomy, pelvic lymph node metastasis was high risk factor for recurrence and initial tumor size was closely correlated with pelvic lymph node invasion even after neoadjuvant chemotherapy.