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International Journal of Clinical Oncology

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

Published in:
Authors
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
Published in
International Journal of Clinical Oncology | Issue 4/2026

Abstract

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.
Title
Evaluation of neoadjuvant chemotherapy followed by radical hysterectomy in cervical cancer: a single-center study
Authors
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
Publication date
04-03-2026
Publisher
Springer Nature Singapore
Published in
International Journal of Clinical Oncology / Issue 4/2026
Print ISSN: 1341-9625
Electronic ISSN: 1437-7772
DOI
https://doi.org/10.1007/s10147-026-02998-0
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