Cervical cancer represents the second commonest cancer in women worldwide, with 500,000 new
cases and 300,000 deaths reported yearly. Among cervical cancer cases, 80% occur in
developing countries and about 70% are identified as advanced cancer. According to the
International Federation of Gynecology and Obstetrics (FIGO) staging system, a locally
advanced cervical cancer includes stage IB2 to IIB.
Treatment modalities include radical surgery with or without adjuvant radiotherapy (RT),
Neoadjuvant Chemotherapy (NAC) plus radical hysterectomy with or without adjuvant RT, and
concomitant chemo radiation. Currently, platinum based concurrent chemoradiotherapy is the
gold standard for locally advanced cervical carcinoma.
Neoadjuvant chemotherapy has many advantages: decreasing tumor size making surgery easier
with improved rate of complete resection, decreased pelvic recurrence rate significantly,
decreasing rate of parametrial invasion and lymph node metastasis, better brachytherapy
distribution, minimal radiation toxicity, and 15% absolute increase of 5-year survival.
This study will evaluate various factors i.e. patient related (Age, Menopausal status, HPV,
HIV, Comorbidities), Tumor related pathological stages (TNM), grade, lymphovascular
perineural invasion, lymph nodes, extranodal extension, tumor margins including radial
margin, type of tumor i.e. Adeno vs squamous, mutation profile and Treatment related factors
(type of NAC, duration of NAC, no of cycles of NAC).