Objective    To study the significance of neoadjuvant chemotherapy（NACT）for pelvic lymphatic metastasis in patients with early bulky cervical cancer and their survival.     Methods    Clinical data about 165 patients with stage Ⅰb

2

/Ⅱa bulky cervical cancer were retrospectively analyzed. The patients were divided into NACT group (n=68) and direct operation group (n=97). Lymphatic metastasis and survival rates were compared in the two groups.     Results    No significant difference was found in lymphatic meta

stasis between the two groups (13.2% vs 16.5%

P=0.565). However

the lymphatic metastasis rate was significantly lower in patients who responded to NACT than in those who did not respond to NACT (4.8% vs 26.9%

P=0.031) while the pelvic lymphatic metastasis rate was lower in NACT group than in direct operation group (1.2% vs 2.8%

P=0.002). By the end of follow-up

the 5-year survival rate was lower in patients with positive lymphatic metastasis than in those with negative lymphatic metastasis (63.0% vs 86.0%

P=0.252) while higher in NACT group than in direct operation group (91% vs 77%

P=0.274) and in patients who responded to NACT than in those who did not respond to NACT (93% vs 87%

P=0.145).     Conclusion    NACT can control the involved lymph nodes in cervical cancer with no significant effect on the 5-year and total survival rates of patients with early bulky cervical cancer.