Abstract：Objective: To investigate the efficacy and prognostic factors for patients receiving
neoadjuvant chemotherapy (NACT) before operation in stage IB2 and IIA2 cervical cancer.
Methods: A total of 187 patients with IB2 and IIA2 cervical cancer who received NACT
combined surgery from January 2005 to January 2016 were enrolled. All patients were
divided into an effective group (n=142) and an ineffective group (n=45) according to the chemotherapy efficacy. Clinical characteristics (containing tumor diameter, hematological
inflammatory indexes, etc.) before chemotherapy and postoperative pathology between the
two groups were compared. Patient survival analysis was performed by Kaplan-Meier
method. The methods of univariate and multifactor analysis were used to analyze the
relationship between NACT curative effect, postoperative pathological factors, and survival
of patients.
Results: The number of patients with tumor diameter less than 5 cm was more in the
chemotherapy effective group than that in the ineffective group (P=0.015). Three
hematological inflammatory indexes (systemic inflammatory response index, neutrophillymphocyte
ratio, and monocyte-lymphocyte ratio) in the effective group were lower than
those in the ineffective group, respectively (P<0.05). The rates of pelvic lymph node
metastasis and cervical deep myometrial invasion in the effective group were lower than
those in the ineffective group (P<0.05). The 3-year and 5-year overall survival of NACT
patients were 92.6% and 82.9%, respectively. Univariate analysis showed that
chemotherapy efficacy, hematological inflammatory indexes, pelvic lymph node
metastasis, and cervical deep myometrial invasion were related to the survival of patients
(P<0.05). Further multivariate analysis demonstrated that pelvic lymph node metastasis
was an independent risk factor for survival of patients (P<0.001), whereas effective NACT
treatment was a protective factor for survival of patients (P<0.001).
Conclusion: Tumor diameter and hematologic inflammation indexes before treatment are
the relevant factors for NACT efficacy in patients with IB2 and IIA2 cervical cancer.
Chemotherapy efficacy and pelvic lymph node metastasis are prognostic factors for NACT
patients.
邹婷婷，郑春莹，张志邦，余立，符淳. 187例IB2和IIA2期宫颈癌新辅助化疗疗效及预后的影响因素[J]. 中南大学学报(医学版), 2020, 45(3): 297-304.
ZOU Tingting, ZHENG Chunying, ZHANG Zhibang, YU Li, FU Chun. Neoadjuvant chemotherapy efficacy and prognostic factors in 187 cervical cancer patients with IB2 and IIA2 stage. Journal of Central South University(Medical Scienc, 2020, 45(3): 297-304.
