Neoadjuvant chemotherapy for locally advanced stage (IB2-IIA2-IIB) cervical carcinoma: Experience of a tertiary center and comprehensive review of the literature

Öz:

Objective: This study aimed to evaluate neoadjuvant chemotherapy (NACT) for locally advanced stage cervical carcinoma. Materials and Methods: Data of 43 patients with locally advanced cervical carcinoma who had NACT were reviewed. NACT protocols implemented included cisplatin/5-fluorauracil, cisplatin/UFT, and carboplatin/paclitaxel. After NACT, the patients were re-examined, and patients who had a tumor size ≤40 mm underwent Piver-Rutledge type III radical hysterectomy, while other patients received radiotherapy. Following NACT, clinical responses were assessed according to the criteria of the World Health Organization. Results: The mean age of the patients was 49.4 years, and the median follow-up duration was 48 (range, 5-228) months. The median tumor sizes were 50 and 30 mm before and after NACT, respectively. Complete clinical response was observed in 4 (9.3%) patients, partial clinical response in 8 (18.6%), and pathologic complete response in 3 (6.9%). Stable disease was noted in 30 (69.9%) patients and progression in 1 (2.3%) patient. After NACT, 31 patients have undergone radical surgical procedures. The 5-year disease-free survival rate was 72%, and the 5-year disease-specific survival rate was 91%. Age, International Federation of Gynaecology and Obstetrics 2009 stage, histopathologic type, NACT protocol, rate of decrease in tumor size after NACT, clinical response, number of courses, tumor size before NACT, tumor size after NACT, and lymph node metastasis were not associated with disease-free survival. Conclusion: Following NACT, a significant reduction in tumor dimension was observed, and the probability of radical surgery is increased. However, clinical response was not predictive of survival.

Anahtar Kelime:

Lokal olarak ileri evre (IB2-IIA2-IIB) servikal karsinom için neoadjuvan kemoterapi: Tersiyer merkez deneyimi ve literatürün kapsamlı incelemesi

Öz:

Amaç: Bu çalışmada neoadjuvan kemoterapinin (NACT) etkinliği değerlendirilmiştir. NACT, lokal olarak ilerlemiş servikal karsinomda başlangıç tedavisi için yöntemlerden biridir. Gereç ve Yöntemler: Lokal olarak ilerlemiş servikal karsinomlu, NACT olan 43 hastanın verileri gözden geçirildi. NACT protokolleri sisplatin/5-fluorourasil, sisplatin/UFT ve karboplatin/paklitaksel idi. NACT sonrası hastalar tekrar muayene edildi ve tümör boyutu 40 mm ve altı olan hastalar ameliyat edildi (Piver-Rutledge tip III radikal histerektomi) ve diğer hastalara radyoterapi verildi. NACT klinik yanıtı, Dünya Sağlık Örgütü kriterlerine göre değerlendirildi. Bulgular: Hastaların ortalama yaşı 49,4 yıl ve ortanca takip süresi 48 (aralık, 5-228) aydı. Ortalama tümör boyutu NACT’den önce 50 mm ve NACT’den sonra 30 mm idi. Yanıt oranları aşağıdaki gibidir; dört hastada (%9,3) tam klinik yanıt, sekiz hastada (%18,6) kısmi klinik yanıt ve üç hastada (%6,9) patolojik tam yanıt. Otuz hastada (%69,9) stabil hastalık ve bir hastada (%2,3) progresyon görüldü. NACT’den sonra 31 hasta radikal cerrahi prosedür geçirdi. Beş yıllık hastalıksız sağkalım %72,5 yıllık hastalığa özgü sağkalım %91 idi. Yaş, Uluslararası Jinekoloji ve Obstetrik Federasyonu 2009 evresi, histopatolojik tip, NACT protokolü, NACT sonrası tümör boyutundaki azalma oranı, klinik yanıt, kurs sayısı, NACT öncesi tümör boyutu, NACT sonrası tümör boyutu ve lenf nodu metastazı hastalıksız sağkalım ile ilişkili değildi. Sonuç: NACT sonrası tümör boyutunda önemli bir azalma oldu ve radikal cerrahi olasılığı arttı. Ancak klinik yanıt, sağkalımı tahmin etmedi.

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	Çakır C, Kilic F, DUR R, Yüksel D, Ünsal M, KORKMAZ v, Kilic C, Kimyon Comert G, Boran N, turkmen o, KOC S, Turan T (2021). Neoadjuvant chemotherapy for locally advanced stage (IB2-IIA2-IIB) cervical carcinoma: Experience of a tertiary center and comprehensive review of the literature. , 190 - 202.
Chicago	Çakır Caner,Kilic Fatih,DUR RIZA,Yüksel Dilek,Ünsal Mehmet,KORKMAZ vakkas,Kilic Cigdem,Kimyon Comert Gunsu,Boran Nurettin,turkmen osman,KOC SEVGİ,Turan Taner Neoadjuvant chemotherapy for locally advanced stage (IB2-IIA2-IIB) cervical carcinoma: Experience of a tertiary center and comprehensive review of the literature. (2021): 190 - 202.
MLA	Çakır Caner,Kilic Fatih,DUR RIZA,Yüksel Dilek,Ünsal Mehmet,KORKMAZ vakkas,Kilic Cigdem,Kimyon Comert Gunsu,Boran Nurettin,turkmen osman,KOC SEVGİ,Turan Taner Neoadjuvant chemotherapy for locally advanced stage (IB2-IIA2-IIB) cervical carcinoma: Experience of a tertiary center and comprehensive review of the literature. , 2021, ss.190 - 202.
AMA	Çakır C,Kilic F,DUR R,Yüksel D,Ünsal M,KORKMAZ v,Kilic C,Kimyon Comert G,Boran N,turkmen o,KOC S,Turan T Neoadjuvant chemotherapy for locally advanced stage (IB2-IIA2-IIB) cervical carcinoma: Experience of a tertiary center and comprehensive review of the literature. . 2021; 190 - 202.
Vancouver	Çakır C,Kilic F,DUR R,Yüksel D,Ünsal M,KORKMAZ v,Kilic C,Kimyon Comert G,Boran N,turkmen o,KOC S,Turan T Neoadjuvant chemotherapy for locally advanced stage (IB2-IIA2-IIB) cervical carcinoma: Experience of a tertiary center and comprehensive review of the literature. . 2021; 190 - 202.
IEEE	Çakır C,Kilic F,DUR R,Yüksel D,Ünsal M,KORKMAZ v,Kilic C,Kimyon Comert G,Boran N,turkmen o,KOC S,Turan T "Neoadjuvant chemotherapy for locally advanced stage (IB2-IIA2-IIB) cervical carcinoma: Experience of a tertiary center and comprehensive review of the literature." , ss.190 - 202, 2021.
ISNAD	Çakır, Caner vd. "Neoadjuvant chemotherapy for locally advanced stage (IB2-IIA2-IIB) cervical carcinoma: Experience of a tertiary center and comprehensive review of the literature". (2021), 190-202.

APA	Çakır C, Kilic F, DUR R, Yüksel D, Ünsal M, KORKMAZ v, Kilic C, Kimyon Comert G, Boran N, turkmen o, KOC S, Turan T (2021). Neoadjuvant chemotherapy for locally advanced stage (IB2-IIA2-IIB) cervical carcinoma: Experience of a tertiary center and comprehensive review of the literature. Turkish Journal of Obstetrics and Gynecology, 18(3), 190 - 202.
Chicago	Çakır Caner,Kilic Fatih,DUR RIZA,Yüksel Dilek,Ünsal Mehmet,KORKMAZ vakkas,Kilic Cigdem,Kimyon Comert Gunsu,Boran Nurettin,turkmen osman,KOC SEVGİ,Turan Taner Neoadjuvant chemotherapy for locally advanced stage (IB2-IIA2-IIB) cervical carcinoma: Experience of a tertiary center and comprehensive review of the literature. Turkish Journal of Obstetrics and Gynecology 18, no.3 (2021): 190 - 202.
MLA	Çakır Caner,Kilic Fatih,DUR RIZA,Yüksel Dilek,Ünsal Mehmet,KORKMAZ vakkas,Kilic Cigdem,Kimyon Comert Gunsu,Boran Nurettin,turkmen osman,KOC SEVGİ,Turan Taner Neoadjuvant chemotherapy for locally advanced stage (IB2-IIA2-IIB) cervical carcinoma: Experience of a tertiary center and comprehensive review of the literature. Turkish Journal of Obstetrics and Gynecology, vol.18, no.3, 2021, ss.190 - 202.
AMA	Çakır C,Kilic F,DUR R,Yüksel D,Ünsal M,KORKMAZ v,Kilic C,Kimyon Comert G,Boran N,turkmen o,KOC S,Turan T Neoadjuvant chemotherapy for locally advanced stage (IB2-IIA2-IIB) cervical carcinoma: Experience of a tertiary center and comprehensive review of the literature. Turkish Journal of Obstetrics and Gynecology. 2021; 18(3): 190 - 202.
Vancouver	Çakır C,Kilic F,DUR R,Yüksel D,Ünsal M,KORKMAZ v,Kilic C,Kimyon Comert G,Boran N,turkmen o,KOC S,Turan T Neoadjuvant chemotherapy for locally advanced stage (IB2-IIA2-IIB) cervical carcinoma: Experience of a tertiary center and comprehensive review of the literature. Turkish Journal of Obstetrics and Gynecology. 2021; 18(3): 190 - 202.
IEEE	Çakır C,Kilic F,DUR R,Yüksel D,Ünsal M,KORKMAZ v,Kilic C,Kimyon Comert G,Boran N,turkmen o,KOC S,Turan T "Neoadjuvant chemotherapy for locally advanced stage (IB2-IIA2-IIB) cervical carcinoma: Experience of a tertiary center and comprehensive review of the literature." Turkish Journal of Obstetrics and Gynecology, 18, ss.190 - 202, 2021.
ISNAD	Çakır, Caner vd. "Neoadjuvant chemotherapy for locally advanced stage (IB2-IIA2-IIB) cervical carcinoma: Experience of a tertiary center and comprehensive review of the literature". Turkish Journal of Obstetrics and Gynecology 18/3 (2021), 190-202.