Interesting research was conducted by the Chinese. They showed that after neoadjuvant chemotherapy, the stage can decrease.
https://www.nature.com/articles/srep28278
In Russian specialized medical sites, there was data that clinically determined stage III (we are talking about breast cancer, colorectal cancer), after surgery, histology spoke of stage 1. And there was no neoadjuvant chemotherapy.
There were also studies among different countries that spoke about the dependence of lymphocytic infiltration and the prognosis of the course of cancer. For certain types of t-lymphocytes, the authors reported a positive or pessimistic prognosis.
If you take neoadjuvant chemotherapy and subsequent surgery, then there is a lot of complicated things. Much depends on the clinician. Two clinicians can give one patient a stage 1B2, 2A1, or 2A2. The accuracy of MRI depends on the experience of the operator and the background diseases of the cervix or pelvic organs. The optimal pathological response may also not be an entirely accurate indicator. Since in the case of preoperative overdiagnosis, the histological response to neoadjuvant therapy may be false positive. Because the tumor itself could be significantly lower than it looked on the MRI before the start of chemotherapy. The vascularization that ultrasound sees is also a specific indicator of oncology. Only postoperative histology can show a more or less true situation with the scale of the tumor process.
Preoperative chemotherapy removes foci of necrosis, reduces inflammatory infiltration, slightly reduces the volume of the tumor, the depth of invasion in the stroma, passes into the vagina and spreads to the parametrium. Again, not a single doctor at a clinical examination will not say with 100% certainty that the lesion of the parametrium is caused by a tumor. They say that it is safe to say that this is the transition of the tumor to the parametrium at the 3rd stage, when the tumor infiltration reaches the walls of the pelvis and has characteristic signs. In Russia, at the Institute named after him. In order to avoid overdiagnosis of transitions to the parametrium and vaginal arches, Herzen was additionally injected with a contrast agent (not halidonium) directly into the vagina, but this was not included in routine practice in Russia.
A decrease in the stage after surgery is possible after chemotherapy and this will be considered a good prognosis or the cause of overdiagnosis was pronounced lymphocytic infiltration. As histologists say, after neoadjuvant chemotherapy, the picture of the postoperative material can be distorted and the opinion of two specialists is necessary to obtain accurate results. In addition, specialists should fully study the postoperative material. Two specialists will look at what cancer foci are present in the postoperative material, it often happens that one histologist complements the report of the other. Thorough is always achievable. Often, the removed tissues are examined by a single histologist. And it's not like all the removed tissue. There are certain areas of the removed material that are examined by histologists: the transitional zone of the cervix (the depth of the invasion of the stroma is determined, the spread of the tumor deep into the cervical canal), the lymph nodes and the surgical edge of the resection are necessarily examined by a histologist.
In the literature, there is evidence that microinvasive carcinoma 1a1 8 years after surgical treatment was manifested by a tumor in the lungs. No doctor will say with 100% probability whether the patient will be cured. We can only wish the girls who are being treated for cervical cancer a lifetime of remission. Let the example of this woman be an achievable dream for most https://www.cdc.gov/cancer/cervical/stories/jennie.htm
We wish you all good health and a successful fight against this nasty disease!
