Chemotherapy versus chemoradiotherapy for FIGO stages IB1 and IIA1 cervical squamous cancer patients with lymphovascular space invasion: a retrospective study

Abstract

Purpose To evaluate the impact of different adjuvant therapy on IB1 and IIA1 stage cervical squamous cell cancer patients with lymphovascular space invasion. It also aimed to analyze the relationship between lymphovascular space invasion and other clinical pathological characteristics on IB1 and IIA1 stage cervical squamous cell cancer patients. Methods This retrospective observational study collected data of FIGO stages IB1 and IIA1 squamous cervical cancer patients at the First Affiliated Hospital of Chongqing Medical University between 2014 and 2018. A correlation analysis between lymphovascular space invasion and other clinical or pathological factors was conducted. Prognosis analysis of patients with lymphovascular space invasion were performed to assess associations between clinical-pathological characteristics and survival. Results A total of 357 women were identified including 110 (30.8%) with lymphovascular space invasion, 247 (69.2%) without lymphovascular space invasion. Both middle 1/3 cervical stromal invasion (p = 0.000) and deep 1/3 cervical stromal invasion (p = 0.000) were independently associated with lymphovascular space invasion. Among lymphovascular space involved women, tumor differentiation (P = 0.001) and postoperative therapy (P = 0.036) had a significant influence on disease recurrence. Multivariate analysis showed that lymph node metastasis (P = 0.017), poorer tumor differentiation (P = 0.036) and postoperative chemotherapy alone (P = 0.021) can increase the risk of tumor relapse. Conclusion Our study suggested that the presence of deep stromal invasion independently increases the risk of lymphovascular space invasion. Compared with chemotherapy, chemoradiotherapy seems to improve progression-free survival in squamous cervical cancer patients with lymphovascular space invasion.

Predicting recurrence in intermediate‑ and high‑risk stage IB‑IIB cervical cancer treated with adjuvant cisplatin and paclitaxel chemotherapy post‑radical hysterectomy: The role of TBX2 expression

“…These include urinary disturbances, lower-limb lymphedema, bowel obstruction, sexual and ovarian dysfunction, and mental health issues stemming from these chronic conditions ( 6 – 8 ). Given these complications, there has been a global shift towards exploring adjuvant chemotherapy as an alternative, with promising results reported ( 6 , 7 , 9 , 10 ). A notable randomized non-inferiority multicenter trial showed no significant difference in 3-year progression-free survival rates, which were 91.9% in both the adjuvant chemotherapy and concurrent chemoradiation therapy (CCRT) groups.…”

“…However, irradiation or concurrent chemoradiation following radical surgery can lead to adverse events, including urinary disturbance, lower-limb lymphedema, bowel obstruction, sexual dysfunction, ovarian dysfunction, and mental health issues associated with these lasting adverse effects ( 6 – 8 ). Given these concerns, efforts have been made globally to introduce postoperative adjuvant chemotherapy for patients at intermediate or high risk of recurrence ( 6 , 7 , 9 , 10 ). However, the current evidence supporting chemotherapy as postoperative adjuvant therapy is limited, and careful consideration is warranted when determining its suitability.…”

CLPTM1L expression predicts recurrence of patients with intermediate‑ and high‑risk stage IB‑IIB cervical cancer undergoing radical hysterectomy followed by TP as adjuvant chemotherapy

“…However, the combination of radical hysterectomy and whole-pelvic irradiation or chemoradiation is linked with an increased occurrence of complications such as lower-limb lymphedema, urinary disturbance, bowel obstruction, sexual dysfunction, and mental issues related to those lasting issues (4)(5)(6). Chemotherapy has been reported as an effective post-surgical adjuvant therapy for patients with intermediate-and high-risk stage IB-IIB cervical cancer (7)(8)(9). For these reasons, chemotherapy has been increasingly chosen as post-surgical adjuvant therapy in clinical practice (10,11).…”

Dynamic Nomogram Based on the Metastatic Number and Sites and Therapy Strategies Predicting the Prognosis of Patients with Metastatic Cervical Cancer

“… 10 Since knowledge of the prognosis of metastatic number and sites is crucial for pre-treatment evaluation, our study aimed to analyze the impact of metastases in different systems, such as lymph node (LN) and hematogenous (including lung, liver, bone and other organs) systems, and in specific locations on the prognosis of mCC patients. In addition, previous studies found that definitive pelvic radiotherapy and chemotherapy were associated with significantly longer survival compared with chemotherapy alone for cervical cancer patients, 8 , 11 , 12 but the effect of the appropriate timing of chemoradiotherapy (CRT) in patients with mCC has not been well studied. Until now, many studies related to mCC have contained patients with both synchronous and recurrent metastatic diseases.…”