Abstract：
:Randomized clinical trials comparing neoadjuvant chemotherapy (NAC) followed by surgery with initial surgery in cervical cancer reported conflicting results. We provided a hypothesis explaining the different outcomes between trials. NAC was reported to make a lymph node metastasis smaller. Smaller tumors are hard to detect and potentially undetected at pathologic examination. Undetected metastasis would lead to an erroneous exclusion of high-risk patients from adjuvant therapy. An erroneous exclusion would lead to a recurrence. This harmful concealing effect of NAC could negate the potentially beneficial effect of NAC and the conflicting results of trials could be the result of the balance between harmful and beneficial effect of NAC. Because the concealing effect of NAC can be reversed by adjuvant therapy, trials comparing NAC followed by surgery with initial surgery in which all patients in both arms received adjuvant therapy reported positive result. However, in a trial in which only patients with lymph node or parametrial involvements received adjuvant therapy, the concealing effect was not reversed by adjuvant therapy and reported negative result. Our empirical data showed that patients who underwent NAC followed by surgery and were classified as low-risk based on pathologic parameters had unexpectedly high recurrence rate. To evaluate our hypothesis, a trial comparing a conventional pathologic examination with a more sophisticated examination such as ultrastaging in patients with cervical cancer who received NAC followed by surgery would be necessary. If our hypothesis is proven, trials considering the concealing effect of NAC should be performed to accurately evaluate the role of NAC in cervical cancer.
journal_name
Med Hypothesesjournal_title
Medical hypothesesauthors
Kim K,Kim MJ,Chung HH,Choi SC,Ryu SY,Kim JW,Park NH,Song YS,Kang SBdoi
10.1016/j.mehy.2009.05.026subject
Has Abstractpub_date
2009-12-01 00:00:00pages
1005-7issue
6eissn
0306-9877issn
1532-2777pii
S0306-9877(09)00378-8journal_volume
73pub_type
杂志文章abstract：:Many experimental, clinical and epidemiological data indicate that n-3 and n-6 essential fatty acids are therapeutic nutrients which may delay the development as well as improve the course of cancer. The present hypothesis correlates well with these data and it is proposed that chronic essential fatty acid deficiency,...
journal_title：Medical hypotheses
pub_type： 杂志文章
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更新日期：1997-01-01 00:00:00
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journal_title：Medical hypotheses
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pub_type： 杂志文章
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更新日期：1983-12-01 00:00:00
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journal_title：Medical hypotheses
pub_type： 杂志文章
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更新日期：2011-02-01 00:00:00
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journal_title：Medical hypotheses
pub_type： 杂志文章
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journal_title：Medical hypotheses
pub_type： 杂志文章
doi：10.1016/j.mehy.2010.04.003
更新日期：2010-10-01 00:00:00
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journal_title：Medical hypotheses
pub_type： 杂志文章
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更新日期：1993-10-01 00:00:00
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journal_title：Medical hypotheses
pub_type： 杂志文章
doi：10.1016/j.mehy.2011.06.047
更新日期：2011-10-01 00:00:00
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journal_title：Medical hypotheses
pub_type： 杂志文章
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更新日期：2020-11-01 00:00:00
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journal_title：Medical hypotheses
pub_type： 杂志文章
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更新日期：2004-01-01 00:00:00
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journal_title：Medical hypotheses
pub_type： 杂志文章
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更新日期：2002-02-01 00:00:00
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journal_title：Medical hypotheses
pub_type： 杂志文章
doi：10.1016/j.mehy.2014.07.015
更新日期：2014-10-01 00:00:00
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journal_title：Medical hypotheses
pub_type： 杂志文章
doi：10.1016/j.mehy.2020.109737
更新日期：2020-08-01 00:00:00
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journal_title：Medical hypotheses
pub_type： 杂志文章
doi：10.1016/j.mehy.2005.12.050
更新日期：2006-01-01 00:00:00
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journal_title：Medical hypotheses
pub_type： 杂志文章
doi：10.1016/j.mehy.2020.109698
更新日期：2020-06-01 00:00:00
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journal_title：Medical hypotheses
pub_type： 杂志文章
doi：10.1016/j.mehy.2016.11.020
更新日期：2017-01-01 00:00:00
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journal_title：Medical hypotheses
pub_type： 杂志文章
doi：10.1016/j.mehy.2004.07.027
更新日期：2004-01-01 00:00:00
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journal_title：Medical hypotheses
pub_type： 杂志文章
doi：10.1016/j.mehy.2013.09.031
更新日期：2013-12-01 00:00:00
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journal_title：Medical hypotheses
pub_type： 杂志文章
doi：10.1016/j.mehy.2012.06.002
更新日期：2012-09-01 00:00:00
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journal_title：Medical hypotheses
pub_type： 杂志文章
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更新日期：1998-05-01 00:00:00
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journal_title：Medical hypotheses
pub_type： 杂志文章
doi：10.1016/0306-9877(91)90142-l
更新日期：1991-11-01 00:00:00
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journal_title：Medical hypotheses
pub_type： 杂志文章
doi：10.1016/j.mehy.2020.109801
更新日期：2020-09-01 00:00:00
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journal_title：Medical hypotheses
pub_type： 杂志文章
doi：10.1016/j.mehy.2017.12.006
更新日期：2018-01-01 00:00:00
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journal_title：Medical hypotheses
pub_type： 杂志文章
doi：10.1016/0306-9877(86)90006-x
更新日期：1986-10-01 00:00:00
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journal_title：Medical hypotheses
pub_type： 杂志文章
doi：10.1016/j.mehy.2020.109558
更新日期：2020-04-01 00:00:00
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journal_title：Medical hypotheses
pub_type： 杂志文章,评审
doi：10.1054/mehy.2000.1094
更新日期：2001-01-01 00:00:00
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journal_title：Medical hypotheses
pub_type： 杂志文章
doi：10.1054/mehy.1999.1026
更新日期：2000-07-01 00:00:00
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journal_title：Medical hypotheses
pub_type： 杂志文章
doi：10.1016/0306-9877(89)90047-9
更新日期：1989-03-01 00:00:00
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journal_title：Medical hypotheses
pub_type： 杂志文章
doi：10.1016/j.mehy.2008.08.029
更新日期：2009-03-01 00:00:00
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journal_title：Medical hypotheses
pub_type： 杂志文章
doi：10.1054/mehy.1999.0852
更新日期：2000-03-01 00:00:00
