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).