论文部分内容阅读
Objective: The aim of this study was to explore the difference of long-term prognosis of different treatment regimens in patients with stage IB2, IIA2 cervical cancer. Methods: From August 1995 to September 2005, radical hysterectomy was chosen as primary treatment regimen for 122 patients (group A), 85 patients underwent radical hysterectomy after effective neoadjuvant therapy (group B), and 98 patients received surgery after ineffective preoperative therapy (group C). All patients received postoperative therapy. Results: A total of 305 patients were analyzed. The maximum diameter of tumor was largest in group B, while the pathological risk factors (cervical infiltration, positive surgical margins) were in the lowest proportion. The 5-year mortality rate and relapse rate of group B were the highest, and the overall survival (OS) and progression-free survival (PFS) were the shortest (P < 0.05). No significant difference of long-term survival was found in group C and group A. No difference was found in the surgical of three groups. Large tumor more than 5.5 cm had higher effective ratio of treatment than those 5.5 cm or less. Patients received effective preoperative radiotherapy had better long-term prognosis than those received chemotherapy or radiochemotherapy. Conclusion: neoadjuvant treatment using for patients with IB2, IIA2 cervical cancer is effective in reducing risk factors of pathological, but it could not improve the long-term survival. The indications of adjuvant therapy after surgery should be reconsidered. Those tumors of diameter 5.5 cm or less response poor to neoadjuvant treatment, and no improvement of survival was found, so direct surgical treatment is suggested for these patients. Radiotherapy is a better choice of preoperative treatment.