Abstract
Objective: The objective is to evaluate the effectiveness of chemotherapy as postoperative adjuvant therapy for stage IB-IIB cervical cancer with intermediate-risk factors. Methods: We retrospectively reviewed the medical records of 119 cervical cancer patients with intermediate-risk factors treated with radical hysterectomy and pelvic lymphadenectomy from December 1997 to September 2010. The intermediate-risk factors included bulky tumor (≥4 cm), lymphovascular space invasion, and deep stromal invasion. Sixteen patients did not receive adjuvant therapy (observation group); 73 were treated with chemotherapy (CT group); 30 were treated with adjuvant radiation therapy (RT group). The significance of the clinical parameters, 3- and 5-year overall survival (OS) rates of each group, was analyzed. Results: The 3- and 5-year OS rates between the observation group and adjuvant therapy group (CT plus RT groups) were not statistically different (3-year OS: 100% and 94.4%, respectively; 5-year OS: 100% and 92.3%, respectively; p > 0.05). The 3- and 5-year OS rates between the CT group and RT group were also not statistically different (3-year OS: 93.6% and 96.4%, respectively; 5-year OS: 80.7% and 96.4%, respectively; p Univariate and multivariate analysis of survival indicated that different adjuvant therapies were not independent prognostic indicators for IB-IIB cervical cancer patients with intermediate-risk factors. Conclusions: CT may have equivalent therapeutic effect as RT for stage IB-IIB cervical cancer patients with intermediate-risk factors after radical surgery, and prospective randomized trial is needed to study the effect of CT in these patients.
Highlights
Radiotherapy (RT) is widely accepted as postoperative adjuvant therapy for reducing recurrence in patients with cervical cancer
The aim of this study was to compare the outcome of CT and radiation as adjuvant therapy for patients with Federation of Gynecology and Obstetrics (FIGO) stage IB-IIB cervical cancer and surgically confirmed intermediate-risk factors
Neoadjuvant interventional CT was administered to 50 patients of squamous cell carcinoma (SCC) with tumors > 4 cm
Summary
Radiotherapy (RT) is widely accepted as postoperative adjuvant therapy for reducing recurrence in patients with cervical cancer. Intermediate-risk factors for recurrence after radical hysterectomy include lymphovascular space invasion (LVSI), tumor size ≥ 4 cm, and deep stromal invasion (DSI) [1]. According to the International Federation of Gynecology and Obstetrics (FIGO) clinical practice guidelines for gynecological cancers (2010) and National Comprehensive Cancer Network (NCCN) cervical cancer guidelines (2013), adjuvant treatment for patients with these intermediate-risk factors includes observation and RT with or without cisplatin-based chemotherapy (CT). Chemotherapy is expected to play therapeutical effect and may be recommended for patients with intermediate-risk factors, especially young patients. There are only a few reports on the effectiveness of adjuvant CT in patients with intermediate-risk factors after radical surgery. The aim of this study was to compare the outcome of CT and radiation as adjuvant therapy for patients with FIGO stage IB-IIB cervical cancer and surgically confirmed intermediate-risk factors
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