Comparison of adjuvant chemotherapy and radiation in patients with intermediate risk factors after radical surgery in FIGO stage IB–IIA cervical cancer

Abstract

The aim of this study was to compare the outcome of chemotherapy or radiation as adjuvant therapy for patients with FIGO stage IB-IIA cervical cancer and surgically confirmed intermediate risk factors. Data were collected from patients with uterine cervical cancer FIGO stage IB-IIA who had adjuvant chemotherapy following radical hysterectomy with pelvic lymph node dissection (RHLND, cases) or adjuvant radiotherapy following RHLND (controls). The study groups consisted of 38 cases and 42 controls. Adjuvant treatment was given to the patients with a combination of intermediate risk factors including deep stromal invasion (>50%), lymphvascular space invasion, large tumor size (3-6 cm), or close vaginal resection margin (<1 cm). Comparison of the cases with the controls revealed no significant differences in variables studied including median age (P = 0.18), stage distribution (P = 0.30), histologic subtype (P = 0.93), pathologic tumor size (P = 0.46), depth of the stromal invasion (P = 0.29), lymphvascular space invasion (P = 0.50), and close vaginal resection margin (P = 0.62). The difference in disease-free survival rates was not significant (P = 0.68). However, the overall survival analysis was incomplete due to the limited number of events available at the end of the study period. The findings of this study suggest that adjuvant chemotherapy in patients with FIGO stage IB-IIA uterine cervical cancer and surgically confirmed intermediate risk factors may be effective.

NR2F6 Expression Correlates with Pelvic Lymph Node Metastasis and Poor Prognosis in Early-Stage Cervical Cancer

“…Various guidelines, including those of the National Cancer Institute [29], National Comprehensive Cancer Network [30], and the European Society of Medical Oncology [31], recommend concurrent chemoradiotherapy (CCRT) or radiation therapy (RT) as the standard adjuvant treatment after RH. However, several recent retrospective studies have indicated that, for patients with intermediate risk factors, adjuvant chemotherapy (cisplatin (CDDP) based combination regimens) alone had at least equal survival effects compared with postoperative RT [32,33,34,35,36,37]. In our study, patients with high or intermediate risk factors, i.e., PLNM, positive parametrial involvement, positive surgical margin, deep stromal invasion, positive lymphovascular space involvement, large tumor (>4 cm), and high differentiation grade, received chemotherapy and/or radiotherapy.…”

Parametrial involvement in women with low-risk, early-stage cervical cancer

“…As a result of this, the criteria to consider adjuvant radiotherapy was revised and the ratio ended up inconsistent due to the presence or absence of other risks such as positive LVSI and larger tumour size (Sedlis et al, 1999). To further exacerbate the problem, many studies defined deep stromal invasion as having stromal involvement of more than 50% (Lee et al, 2008;Takeshima et al, 2006). In this study, patients with parametrial involvement had stromal invasion of more than 50%, whereas those without parametrial involvement had stromal invasion of less than 50%.…”

Analysis of Prognostic Factors Affecting the Outcome of Stage IB-IIB Cervical Cancer Treated by Radical Hysterectomy and Pelvic Lymphadenectomy

“…20 The potential effect of cisplatin-based chemotherapy was also observed in carcinoma of the cervix. 21,22 It was controversial whether there was survival benefit in patients receiving postoperative chemotherapy plus radiotherapy with pathologic risk factors. 13 In our study, there was no significant difference in both 3-year DFS (P = 0.984) and OS (P = 0.646) rates between the patients with adjuvant therapy and patients without adjuvant therapy.…”