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Background <p>The efficacy of neoadjuvant chemotherapy (NACT) before radical hysterectomy (RH) in cervical cancer remains unclear. We evaluated stage-specific outcomes of NACT-RH at a high-volume center.</p> Methods <p>This retrospective cohort study included patients with non-metastatic cT1b1–2b cervical cancer who underwent RH between 2013 and 2022. For cT1b cases, prognostic outcomes were compared between patients with cT1b3 (any N) who underwent NACT-RH (High-risk, NACT(+)) and those with cT1b1–1b2 N0 who underwent primary RH (Low-risk, NACT(−)), using propensity score matching. For cT2 cases, NACT-RH versus primary RH was compared using inverse probability weighting to adjust for baseline differences.</p> Results <p>Among 191 patients who underwent RH (cT1: <i>n</i> = 99; cT2: <i>n</i> = 92), the matched cT1 cohort comprised 15 High-risk, NACT(+) and 30 Low-risk, NACT(−) patients. Five-year progression-free survival (PFS) was 75.0% (95% confidence interval [CI], 53.4–100.0%) versus 89.9% (95% CI, 79.6–100.0%) (<i>p</i> = 0.427). Overall survival (OS) was 100% in both groups with a median follow-up of &gt; 70&#xa0;months. In cT2, NACT-RH (<i>n</i> = 73) versus primary RH (<i>n</i> = 19) showed hazard ratios of 2.88 for PFS (95% CI, 0.69–11.97) and 5.64 for OS (95% CI, 0.70–45.35) after baseline adjustment. Among cT2 patients who underwent NACT-RH, PFS and OS were worse in those without an objective response to NACT (<i>n</i> = 18, all cT2b) than in responders.</p> Conclusion <p>NACT-RH was associated with encouraging long-term outcomes in cT1b3, whereas outcomes in cT2 cases remain uncertain, supporting careful selection and response-adapted strategies.</p>

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Evaluation of neoadjuvant chemotherapy followed by radical hysterectomy in cervical cancer: a single-center study

  • 期刊论文

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  • 发表日期：

    2026年3月4日

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  • Akitoshi Yamamura,
  • Masayo Ukita,
  • Hiromi Takemura,
  • Tetsuya Ishibashi,
  • Hinako Nakanishi,
  • Mariko Kita,
  • Takaya Sakamoto,
  • Airi Toda,
  • Teruki Yoshida,
  • Sayuri Takahashi,
  • Shota Kanbayashi,
  • Hirohiko Tani,
  • Kenzo Kosaka

摘要

Background

The efficacy of neoadjuvant chemotherapy (NACT) before radical hysterectomy (RH) in cervical cancer remains unclear. We evaluated stage-specific outcomes of NACT-RH at a high-volume center.

Methods

This retrospective cohort study included patients with non-metastatic cT1b1–2b cervical cancer who underwent RH between 2013 and 2022. For cT1b cases, prognostic outcomes were compared between patients with cT1b3 (any N) who underwent NACT-RH (High-risk, NACT(+)) and those with cT1b1–1b2 N0 who underwent primary RH (Low-risk, NACT(−)), using propensity score matching. For cT2 cases, NACT-RH versus primary RH was compared using inverse probability weighting to adjust for baseline differences.

Results

Among 191 patients who underwent RH (cT1: n = 99; cT2: n = 92), the matched cT1 cohort comprised 15 High-risk, NACT(+) and 30 Low-risk, NACT(−) patients. Five-year progression-free survival (PFS) was 75.0% (95% confidence interval [CI], 53.4–100.0%) versus 89.9% (95% CI, 79.6–100.0%) (p = 0.427). Overall survival (OS) was 100% in both groups with a median follow-up of > 70 months. In cT2, NACT-RH (n = 73) versus primary RH (n = 19) showed hazard ratios of 2.88 for PFS (95% CI, 0.69–11.97) and 5.64 for OS (95% CI, 0.70–45.35) after baseline adjustment. Among cT2 patients who underwent NACT-RH, PFS and OS were worse in those without an objective response to NACT (n = 18, all cT2b) than in responders.

Conclusion

NACT-RH was associated with encouraging long-term outcomes in cT1b3, whereas outcomes in cT2 cases remain uncertain, supporting careful selection and response-adapted strategies.