{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T01:42:31Z","timestamp":1763602951600,"version":"3.45.0"},"reference-count":26,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T00:00:00Z","timestamp":1753660800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Obstet and Gynaecol"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cervical cancer remains a global health concern. Lymph node (LN) metastasis, especially para\u2010aortic LN (PAN) involvement, is a critical prognostic factor. While neoadjuvant chemotherapy (NAC) followed by radical hysterectomy (RH) is used for locally advanced cervical cancer, its therapeutic effect on LN metastases remains uncertain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>\n                      This retrospective study analyzed 110 patients treated with NAC followed by RH. Patients were grouped into nine cIIIC2 cases with PAN metastasis, 81 non\u2010cIIIC2 squamous cell carcinoma (SCC) cases, and 20 non\u2010squamous cell carcinoma (non\u2010SCC) cases. Non\u2010cIIIC2 SCC cases were further divided into four subgroups by LN status: cN1ypN1 (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200916), cN1ypN0 (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200924), cN0ypN1 (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200910), and cN0ypN0 (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200931). Tumor and LN size changes by NAC and survival outcomes were analyzed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In cIIIC2 cases, ypPAN\u2010negative patients showed significantly better 5\u2010year progression\u2010free survival (PFS) compared to ypPAN\u2010positive cases (100% vs. 0%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001). Among non\u2010SCC cases, ypN1 patients (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20099) had poorer outcomes than ypN0 cases (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200911) (5\u2010year PFS: 25% vs. 90%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0005). As for non\u2010cIIIC2 SCC cases, tumor shrinkage rates varied among SCC subgroups: cN0ypN0 (\u221258.3%), cN1ypN0 (\u221245.5%), cN1ypN1 (\u221236.4%), and cN0ypN1 (\u221229.6%). cN0ypN1 cases also showed distinct recurrence patterns, with 66.7% experiencing distant metastases; however, prognosis did not differ among four LN\u2010related groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>NAC can significantly improve prognosis in selected cases where LN metastases are eliminated, particularly in PAN and non\u2010SCC pelvic region metastasis cases. However, such cases are rare, emphasizing the need for better candidate selection and enhanced treatment strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jog.70022","type":"journal-article","created":{"date-parts":[[2025,7,29]],"date-time":"2025-07-29T06:26:30Z","timestamp":1753770390000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Therapeutic impact of neoadjuvant chemotherapy on lymph node metastasis in locally advanced cervical cancer"],"prefix":"10.1111","volume":"51","author":[{"given":"Yuka","family":"Mizuta","sequence":"first","affiliation":[{"name":"Department of Gynecology and Obstetrics, Graduate School of Medicine Kyoto University  Kyoto City Kyoto Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1240-5422","authenticated-orcid":false,"given":"Koji","family":"Yamanoi","sequence":"additional","affiliation":[{"name":"Department 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