Radical hysterectomy alone or combined with neoadjuvant chemotherapy in the treatment of early stage bulky XXXX .

@entity1 @entity5 @entity900 @entity2622 @entity1600 @entity3799 @entity1891 @entity1732 @entity1349
BACKGROUND AND PURPOSE: Early-stage bulky @entity2622 treated with conventional surgery or radiotherapy has a higher rate of recurrence compared to smaller @entity5 at the same stage. Whether neoadjuvant chemotherapy prior to radical hysterectomy can improve survival in early-stage bulky @entity2622 remains unclear. This study was designed to answer this question. METHODS: Fifty-eight @entity1 with @entity5 were included in this retrospective study. Thirty-one had received neoadjuvant chemotherapy before radical hysterectomy, and the other 27 @entity1 underwent surgery alone. The chemotherapeutic regimen was a combination of @entity900 , @entity1891 , and @entity1732 with a 10-day interval for two to three courses. RESULTS: The age, parity, and @entity5 diameter before treatment in the two groups were similar. The mean @entity5 diameter was significantly decreased after neoadjuvant chemotherapy (4.6 +/- 0.8 vs 3.4 +/- 1.5 cm, P = 0.003). @entity1 without neoadjuvant chemotherapy had a significantly higher incidence of parametrial invasion (14/27 vs 7/31, P = 0.022). More involved lymph nodes were found during surgery in @entity1 without neoadjuvant chemotherapy (23.1 +/- 10.5 vs 17.4 +/- 7.1, P = 0.024), but the incidence of @entity1600 was not different between the two groups (18/31 vs 17/27, P = 0.71). The response rate of primary @entity5 to chemotherapy was 48.4% (15/31). No significant differences in clinical and pathologic parameters were found between responders and non-responders. Deep stromal invasion (> or = 3/4 thickness of @entity3799 ) was the only independent prognostic factor for disease-free survival (DFS) and @entity1349 ( @entity1349 ) in the 58 @entity1 and in the 31 @entity1 who received neoadjuvant chemotherapy. Neither neoadjuvant chemotherapy nor the response to it was an independent prognostic factor for DFS or @entity1349 . CONCLUSIONS: Neoadjuvant chemotherapy could reduce the incidence of local invasion for bulky @entity5 but did not improve the DFS or @entity1349 in our @entity1 . Without further randomized study of the effects of neoadjuvant chemotherapy, this treatment should be chosen carefully.
