To evaluate the potential role of preoperative neoadjuvant chemotherapy in patients with cervical cancer, 92 patients with locally advanced cervcal cancer stage IB, IIA and IIB who had completed 4 years of follow-up(from January 1985 to December
1989)
after treated with chemotherapy followed by radical hysterectomy and pelvic lymphnode dissection at the Division of Gynecologic Oncology, Catholic University Medical College, Seoul, Korea, were selected in this study. The treatment regimen was
consisted
of cisplatin 80 mg/m*, bleomycin 15mg/m* and vinblastin 4mg/m* and vinblastin 4mg/m* given as a course(3 weeks interval) of neoadjuvant chemotherapy. All patients were evaluated by clinical and histological response to chemotherapy. The overall
clinical
response rate was 82.6%(28.3% of complete response and 54.3% of partial response). The chemotherapeutic response was more favorable in squamous cell carcinomas(86.9%) than in adenocarcinomas(37.%, P=0.010). The response rate confirmed by surgical
specimen was 15% including microscopic and no residual disease.
Pelvic lymphnode metastasis were found in 17.4%(16/92) of the patients and all nodal metastasis were found among the patients who had a partial response or a stable disease, and only on patient was found in those with a complete
response(p=0.0001).
All patients were passed 4 years follow-up and the 4 year tumor free survival rate in patients with complete response, partial response and stable disease were 96.2%(25/26), 88%(44/50) and 37.5%(6/16). The 4 year tumor free survival rate of high
risk
cervical cancer stage IB, IIA and IIB were 87.9%(36/41), 83.4%(30/36) and 60%(9/15).
This study suggest that preoperative adjuvant chemotherapy may be beneficial in reducing pelvic lymphnode metastasis, reducing recurrences, and prolonging the survival of the patients with locally advanced high risk cervical cancer stage I and
II.
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