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  • Pathologic Response Rate After Concomitant Neo-Adjuvant Radiotherapy and Chemotherapy for Adenocarcinoma of the Uterine Cervix: A Retrospective Multicentric Study

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Cervical Cancer
Pathologic Response Rate After Concomitant Neo-Adjuvant Radiotherapy and Chemotherapy for Adenocarcinoma of the Uterine Cervix: A Retrospective Multicentric Study
  1. Olivier Poujade, MD*,
  2. Philippe Morice, MD†,
  3. Roman Rouzier, MD, PhD‡,
  4. Patrick Madelenat, MD§,
  5. Fabrice Lecuru, MD∥,,**,
  6. Jean-Michel Muray, MD†,‡,
  7. Patrice Mathevet, MD†,‡,
  8. Séverine Alran, MD§§,
  9. Remy J. Salmon, MD§§ and
  10. Fabien Reyal, MD§§
  1. * Service de Gynécologie-Obstétrique, Hôpital Beaujon, Clichy;
  2. † Service de Chirurgie, Institut Gustave Roussy, Villejuif;
  3. ‡ Servicede Gynécologie-Obstétrique, Hôpital Tenon;
  4. § Service de Gynécologie-Obstétrique, Hôpital Bichat-Claude-Bernard;
  5. ∥ Servicede Chirurgie Gynécologique et Cancérologique, Hôpital EuropéenGeorges-Pompidou;
  6. Faculté de Médecine, and
  7. ** Service c INSERM UMR-S 747, Université Paris-Descartes;
  8. †† Service de Gynécologie-Obstétrique, Centre Hospitalier René Dubos, Pontoise;
  9. ‡‡ Service de Gynécologie-Obstétrique, Pavillon L, Hôpital Édouard-Herriot, Lyon; and
  10. §§ Service de Chirurgie, Institut Curie, Paris, France.
  1. Address correspondence and reprint requests to Olivier Poujade, MD, Service de Gynécologie-Obstétrique, Hôpital Beaujon AP-HP, 100 bd Gén Leclerc, 92110 Clichy, France. E-mail: olivierpoujade{at}hotmail.com.

Abstract

Introduction: Exclusive chemoradiotherapy (including brachytherapy) is the current standard of care for locoregionally advanced cervical cancer. The aim of the present study was to evaluate the responsiveness and to identify factors predicting the response to concomitant chemoradiotherapy before surgery in cervical adenocarcinoma.

Methods: A multicentric retrospective study was done in 9 French centers. A total of 54women with cervical adenocarcinoma stage IB2 to IIIB who had undergone concurrent chemoradiation therapy followed by surgical treatment were included. The patients were stratified by histopathologic response after concomitant chemoradiotherapy (lesions smaller than 1 cm or larger).

Results: The median (SD) age at diagnosis was 44.2 (12.4) years (range, 19.3-77 years). The median (SD) follow-up duration was 30.9 (36.5) months (range, 4.1-17 years). After clinical evaluation, the mean (SD) tumor size was 5 (1.2) cm (range, 2-7 cm).

The patients achieved a clinical complete response after concurrent chemoradiation in 18 cases (33.5%). Pathologic residual tumor was noted in 36 cases (67%); tumors smaller than 1 cm were found in 18 cases (33.5%), and lesions greater than 1 cm were observed in 18 cases (33.5%). Factors being associated with a significant decreased sensitivity to neoadjuvant chemoradiotherapy were the following: menopause (P = 0.012), parametrial invasion (P < 0.001), lymphvascular space invasion (P = 0.003), and mucinous subtype (P = 0.001).

Conclusions: Identification of predictive markers associated with incomplete response to neoadjuvant chemoradiotherapy in cervical adenocarcinoma may prove clinically useful and implement an individualized treatment plan.

  • Cervical adenocarcinoma
  • Chemoradiotherapy
  • Neoadjuvant
  • Surgery

https://doi.org/10.1111/IGC.0b013e3181df7406

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