Outcome evaluation of neoadjuvant chemotherapy in patients with stage IB2 or IIA cervical cancer: a retrospective comparative study

Background: To study the benefits of neoadjuvant chemotherapy (NACT) in addition to surgical resection and postoperative chemoradiotherapy (CRT) in patients with stage IB2 or IIA cervical cancer. Methods: We retrospectively analyzed 363 patients with stage IB2 or IIA cervical cancer that received the surgical resection and postoperative CRT with or without NACT at the Second Hospital of Jilin University between February 2014 and December 2016. We chose mortality as the primary outcome, and the clinical deterioration as secondary outcome. These outcomes were compared between two groups of patients with or without NACT by univariate or multivariate logistic regression analysis. Results: Among the 363 identified patients, 114 patients were in the neoadjuvant group and 249 patients in the non-neoadjuvant group. The median follow-up period was 36.4 months, ranging from 28 to 55 months. There were statistically significant differences in the tumor differentiation, clinical stages, vascular tumor thrombus, and postoperative radiotherapy between these two group patients. After adjusting for these variables, patients in the neoadjuvant group had a statistically significantly lower survival rate than those in the non-neoadjuvant group within one year after the treatment, but this difference disappeared at the 3-year follow-up period. Also, more patients in the neoadjuvant group experienced clinical deterioration at the 3-year follow-up period. Conclusions: NACT did not show significant benefits in mortality and clinical deterioration in patients with stage IB2 or IIA cervical cancer.