Article Data

  • Views 1099
  • Dowloads 251

Original Research

Open Access

Effectiveness of neoadjuvant chemotherapy followed by radical surgery in young patients with locally advanced cervical cancer

  • Lin Gong1
  • Ru-Tie Yin1
  • Qing-Li Li1
  • Ce Bian1
  • Zhi-Lan Peng1,*,

1Department of Obstetrics and Gynecology, West China Second Hospital, West China Center of Medical Sciences, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Sichuan University, 610041 Chengdu, Sichuan, China

DOI: 10.22514/ejgo.2023.003 Vol.44,Issue 1,February 2023 pp.26-33

Submitted: 08 June 2022 Accepted: 02 August 2022

Published: 15 February 2023

*Corresponding Author(s): Zhi-Lan Peng E-mail:


To investigate the efficacy and survival benefit of neoadjuvant chemotherapy (NACT) followed by type C radical surgery in patients with locally advanced cervical cancer (LACC) and moderate risk factors for recurrence. The clinical and pathological data of 338 cases with stage IB3 and IIA2 cervical carcinoma who received NACT followed by radical surgery from January 2008 to December 2018 were collected. In line with the clinical response, the patients were divided into a chemotherapy-effective group (n = 309) and a chemotherapy-ineffective group (n = 29), and the clinical and pathological characteristics of the two groups were compared. Survival was analyzed using the Kaplan-eier method. After NACT and surgical resection, 309 (91.4%, 309/338) patients experienced a clinical response. Fewer patients had a maximum tumor diameter ≥5 cm in the chemotherapy-effective group compared with the chemotherapy-ineffective (p = 0.021). The 5-year progression-free survival (PFS) and overall survival (OS) rates were higher in the chemotherapy-effective group (86.29% and 85.75%, respectively) than in the chemotherapy-ineffective group (77.64% and 75.56%, respectively; p < 0.001). Among patients with high-risk and moderate-risk factors, the 5-year PFS and OS rates were higher in the patients who received chemotherapy (95.90% and 94.81%) than in those who received CCRT (78.06% and 77.25%, respectively; p < 0.001). NACT followed by surgical resection may be an appropriate treatment strategy for young patients with LACC, allowing them to avoid radiochemotherapy and the resultant damage to ovarian and vaginal function. A future prospective study of this treatment strategy is warranted.


Locally advanced cervical cancer; Neoadjuvant chemotherapy; Young patients; Risk factors

Cite and Share

Lin Gong,Ru-Tie Yin,Qing-Li Li,Ce Bian,Zhi-Lan Peng. Effectiveness of neoadjuvant chemotherapy followed by radical surgery in young patients with locally advanced cervical cancer. European Journal of Gynaecological Oncology. 2023. 44(1);26-33.


[1] Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Erratum: global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: A Cancer Journal for Clinicians. 2020; 70: 313.

[2] Feng R, Zong Y, Cao S, Xu R. Current cancer situation in China: good or bad news from the 2018 global cancer statistics? Cancer Communications. 2019; 39: 22.

[3] Zhu Y, Yang J, Zhang X, Chen D, Zhang S. Acquired treatment response from neoadjuvant chemotherapy predicts a favorable prognosis for local advanced cervical cancer: a meta-analysis. Medicine. 2018; 97: e0530.

[4] Shimada M, Nagao S, Fujiwara K, Takeshima N, Takizawa K, Shoji T, et al. Neoadjuvant chemotherapy with docetaxel and carboplatin followed by radical hysterectomy for stage IB2, IIA2, and IIB patients with nonsquamous cell carcinoma of the uterine cervix. International Journal of Clinical Oncology. 2016; 21: 1128–1135.

[5] Zhao H, He Y, Zhu L, Wang J, Guo H, Xu T, et al. Effect of neoadjuvant chemotherapy followed by radical surgery for FIGO stage IB2/IIA2 cervical cancer: a multi-center retrospective clinical study. Medicine. 2019; 98: e15604.

[6] Chen Z, Shi Y, Wang S, Lu Q. Meta-analysis showing that early response to neoadjuvant chemotherapy predicts better survival among cervical cancer patients. Oncotarget. 2017; 8: 59609–59617.

[7] Chai LF, Prince E, Pillarisetty VG, Katz SC. Challenges in assessing solid tumor responses to immunotherapy. Cancer Gene Therapy. 2020; 27: 528–538.

[8] Shanbhogue AKP, Karnad AB, Prasad SR. Tumor response evaluation in oncology: current update. Journal of Computer Assisted Tomography. 2010; 34: 479–484.

[9] Kong S, Huang K, Zeng C, Ma X, Wang S. The association between short-term response and long-term survival for cervical cancer patients undergoing neoadjuvant chemotherapy: a system review and meta-analysis. Scientific Reports. 2018; 8: 1545.

[10] Zhou S, Peng F. Patterns of metastases in cervical cancer: a population-based study. International Journal of Clinical and Experimental Pathology. 2020; 13: 1615–1623.

[11] Sun C, Tian X, Liu Z, Li W, Li P, Chen J, et al. Radiomic analysis for pretreatment prediction of response to neoadjuvant chemotherapy in locally advanced cervical cancer: a multicentre study. EBioMedicine. 2019; 46: 160–169.

[12] Fjeldbo CS, Hompland T, Hillestad T, Aarnes E, Günther C, Kristensen GB, et al. Combining imaging- and gene-based hypoxia biomarkers in cervical cancer improves prediction of chemoradiotherapy failure independent of intratumour heterogeneity. EBioMedicine. 2020; 57: 102841.

[13] Leath CA 3rd, Monk BJ. Twenty-first century cervical cancer manage ment: a historical perspective of the gynecologic oncology group/NRG oncology over the past twenty years. Gynecologic Oncology. 2018; 150: 391–397.

[14] Bader AA, Winter R, Moinfar F, Petru E, Pristauz G, Scholz HS, et al. Is intraoperative frozen section analysis of pelvic lymph nodes accurate after neoadjuvant chemotherapy in patients with cervical cancer? Gynecologic Oncology. 2006; 103: 106–112.

[15] Li L, Wu M, Ma S, Tan X, Zhong S. Neoadjuvant chemotherapy followed by radical hysterectomy for stage IB2-to-IIB cervical cancer: a retrospective cohort study. International Journal of Clinical Oncology. 2019; 24: 1440–1448.

[16] Gong L, Zhang JW, Yin RT, Wang P, Liu H, Zheng Y, et al. Safety and efficacy of neoadjuvant chemotherapy followed by radical surgery versus radical surgery alone in locally advanced cervical cancer patients. International Journal of Gynecological Cancer. 2016; 26: 722–728.

[17] Widschwendter P, Janni W, Scholz C, De Gregorio A, De Gregorio N, Friedl TWP. Prognostic factors for and pattern of lymph-node involvement in patients with operable cervical cancer. Archives of Gynecology and Obstetrics. 2019; 300: 1709–1718.

[18] Osman MA. Defining the role of neoadjuvant chemotherapy followed by surgery in locally advanced cancer cervix: a meta-analysis of phase III trials. Journal of Obstetrics and Gynecology of India. 2016; 66: 352–357.

[19] Gupta S, Maheshwari A, Parab P, Mahantshetty U, Hawaldar R, Sastri Chopra S, et al. Neoadjuvant chemotherapy followed by radical surgery versus concomitant chemotherapy and radiotherapy in patients with stage IB2, IIA, or IIB squamous cervical cancer: a randomized controlled trial. Journal of Clinical Oncology. 2018; 36: 1548–1555.

[20] Yin M, Zhao F, Lou G, Zhang H, Sun M, Li C, et al. The long-term efficacy of neoadjuvant chemotherapy followed by radical hysterectomy compared with radical surgery alone or concurrent chemoradiotherapy on locally advanced-stage cervical cancer. International Journal of Gynecological Cancer. 2011; 21: 92–99.

[21] He J, Li D, Shen P, Liang W, Kang S, Zhang Y, et al. Comparison of survival outcomes of abdominal radical hysterectomy and radiochemotherapy IIA2 (FIGO2018) cervical cancer: a retrospective study from a large database of 63,926 cases of cervical cancer in China. International Journal of Clinical Oncology. 2022; 27: 619–625.

[22] Ye Q, Yang Y, Tang X, Li J, Li X, Zhang Y. Neoadjuvant chemotherapy followed by radical surgery versus radiotherapy (with or without chemotherapy) in patients with stage IB2, IIA, or IIB cervical cancer: a systematic review and meta-analysis. Disease Markers. 2020; 2020: 1–7.

[23] Allanson ER, Powell A, Bulsara M, Lee HL, Denny L, Leung Y, et al. Morbidity after surgical management of cervical cancer in low and middle income countries: a systematic review and meta-analysis. PLoS One. 2019; 14: e0217775.

Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,500 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

Biological Abstracts Easily discover critical journal coverage of the life sciences with Biological Abstracts, produced by the Web of Science Group, with topics ranging from botany to microbiology to pharmacology. Including BIOSIS indexing and MeSH terms, specialized indexing in Biological Abstracts helps you to discover more accurate, context-sensitive results.

Google Scholar Google Scholar is a freely accessible web search engine that indexes the full text or metadata of scholarly literature across an array of publishing formats and disciplines.

JournalSeek Genamics JournalSeek is the largest completely categorized database of freely available journal information available on the internet. The database presently contains 39226 titles. Journal information includes the description (aims and scope), journal abbreviation, journal homepage link, subject category and ISSN.

Current Contents - Clinical Medicine Current Contents - Clinical Medicine provides easy access to complete tables of contents, abstracts, bibliographic information and all other significant items in recently published issues from over 1,000 leading journals in clinical medicine.

BIOSIS Previews BIOSIS Previews is an English-language, bibliographic database service, with abstracts and citation indexing. It is part of Clarivate Analytics Web of Science suite. BIOSIS Previews indexes data from 1926 to the present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Submission Turnaround Time