Decrease in tumor volume and histologic response to intraarterial neoadjuvant chemotherapy in patients with cervical...

Area of Science:

• Gynecologic Oncology
• Medical Oncology
• Pathology

Background:

• Cervical and endometrial adenocarcinomas are significant gynecologic malignancies.
• Predicting response to neoadjuvant chemotherapy (NAC) is crucial for treatment planning.
• Identifying reliable predictive markers for NAC response is an unmet clinical need.

Purpose of the Study:

• To evaluate clinicopathological and biological markers for predicting immediate NAC response in cervical and endometrial adenocarcinomas.
• To assess the utility of pretreatment tumor volume, PCNA index, p53 expression, nuclear grade, and DNA ploidy.

Main Methods:

• Retrospective analysis of 12 cervical and 16 endometrial adenocarcinoma patients.
• Patients received intraarterial neoadjuvant chemotherapy (cisplatin and doxorubicin) before surgery.
• Tumor volume reduction (MRI) and histologic response were assessed; correlation with pretreatment markers was analyzed.

Main Results:

• In cervical cancer, a higher PCNA index (> or = 40.2%) correlated with greater tumor volume decrease (P < 0.05).
• In endometrial cancer, smaller tumors (< 30.3 cm3) showed significantly greater volume reduction (P < 0.001).
• Pretreatment tumor volume and PCNA index were the only significant predictive factors (P < 0.05) for NAC response.

Conclusions:

• The PCNA index and pretreatment tumor volume are potentially useful predictors of immediate NAC response in cervical and endometrial adenocarcinomas.
• These markers may aid in tailoring neoadjuvant chemotherapy strategies for improved patient outcomes.
• Further validation in larger cohorts is warranted to confirm these findings.