The Comparison of Four Different Treatment Modalities in Bulky Stage Ib and Iia Cervix Cancers

Objective: To compare the effectiveness of four different treatment modalities in International Federation of Gynecology and Obstetrics (FIGO) IB2 and IIA2 bulky cervical cancers. Material and methods: Totally, n = 70 eligible women with bulky (≥4 cm) FIGO IB2 IIA2 cervical cancer that diagnosed and treated at our clinic between the years of 1/1994 1/2010 were reviewed retrospectively. Data regarding demographic and disease related characteristics were obtained for analysis from patients' files. Different treatment modalities (radical hysterectomy followed by adjuvant chemoradiation (RH + CTRT); primary chemoradiotherapy (CTRT); neoadjuvant chemotherapy followed by radical hysterectomy (NACT + RH) and neoadjuvant chemoradiotherapy followed by radical hysterectomy (NACRT + RH) were compared in terms of disease-free survival (DFS) and overall survival (OS) by Kaplan-Meier test. A p value of less than 0.05 was accepted as statistically significant. Results: Sixty-three patients (90%) had Stage IB2 and seven (10%) had stage IIA2 disease. (RH + CRT), (CTRT), (NACT + RH) and (NACRT + RH) were performed to 32, 23, 10 and 5 patients, respectively. Mean follow-up period was 78.1 ± 51.6 months [range: 10-210]. Thirteen patients (18.6%) developed recurrence and 10 (14.3%) died from disease. Mean disease-free (DFS) and overall survival (OS) were 64.6 ± 46.7 [4-210] and 68.2 ± 47.3 [10-210] months; respectively. No statistically significant difference was found in terms of survival between four treatment methods (p = 0.85 for DFS and p = 0.9 for OS). Conclusion: The effectiveness of four treatment modalities were similar in terms of survival for patients with bulky FIGO stage IB2 and IIA2 cervical cancers.