Treatment and response
Upfront surgery was undergone in 6 (23.1%) patients: stage II in 1
case, stage III in 4 cases and stage IV in 1 case (unknown the
pathological diagnosis). Tumor size (defined as the greatest extent
measured by MRI scan) was measured ≤4cm×3cm. Four patients achieved CR
and 2 patients had PR after resection. The median of chemotherapy cycles
after resection was 4 (range, 4-6). Twenty (76.9%) patients with
initial tumor size >4cm×3cm received a median of 4 courses
(range, 2-8) neoadjuvant chemotherapy as first line treatment (Table 1).
Primary tumor shrank approximate to 2cm×3cm and AFP declined to
<100ng/ml prior to surgery.
Histopathology after neoadjuvant chemotherapy was notable for nonviable
cells in nine patients. None of them developed relapse. Among the
remaining 11 cases with confirmed malignant disease, 4 patients had no
relapse and 7 patients experienced relapse.
To evaluate assumed prognostic parameters in pathological response to
neoadjuvant chemotherapy, we compared sex, age, AFP level, stage at
diagnosis, number of neoadjuvant chemotherapy cycles and relapse between
good and poor responders. In this analysis, these variables were
comparable for both groups (Table 2).