Impact of various treatment modalities on the outcome of stage IB1–IIA cervical adenocarcinoma

Abstract

Objective To evaluate the outcomes of patients with stage IB1–IIA cervical adenocarcinoma treated by various modalities in order to formulate a better treatment strategy. Methods The impact of various treatment modalities on the prognosis of 258 patients with stage IB1–IIA cervical adenocarcinoma was investigated. The therapeutic modalities included radical surgery (n = 174); radical surgery followed by adjuvant radiation therapy (RT), such as RT alone or concurrent chemo-radiotherapy (CCRT) (n = 46); or primary RT or CCRT (n = 38). Results As compared with patients in the surgery-only group, patients with 1 postoperative major risk who underwent surgery followed by RT or CCRT had a significantly higher likelihood of disease relapse (2.3-fold, P = 0.041) and disease-related death (2.9-fold, P = 0.014). The likelihood of recurrence ( P = 0.32) and death ( P = 0.58) did not differ between patients who underwent adjuvant RT or CCRT for 1 major risk factor and those who underwent primary RT or CCRT. By contrast, patients with more than 1 major risk factor had a higher likelihood of disease recurrence (2.9-fold, P = 0.037) and disease-related death (3.4-fold, P = 0.051) than those who underwent primary RT or CCRT. Conclusion Radical surgery is recommended for patients with stage IB1–IIA cervical adenocarcinomas without contraindications. Those with more than 1 postoperative pathologic risk factor had the worst prognosis despite adjuvant RT or CCRT.