Stage IB2 and IIB cervical cancer in young patients: Treatment results and management proposal

Abstract

Introduction: Advanced cervical cancer (CC) remains a major health problem in our country, with an increasing percentage being diagnosed in young women. Objective: The objective of this study is to present an institutional experience with standard treatment in menstruating women with CC at stages IB2 and IIB, with complementary or rescue surgery being added in selected cases, as well as to propose some management alternatives for these patients. Materials and methods: Analysis of the cases of 45-year-old or younger stage IB2-IIB CC patients who received concomitant chemotherapy and radiotherapy with or without further surgery at the Oncology Department of the Hospital General de México. Results: Ninety-eight patients with a mean age of 37.1 years were treated. In 89 patients, there was follow-up data available, of which 63 (70.7%) had an average evolution of 30 months with no evidence of disease: 12/19 (63.1%) were at stage IB2 and 51/70 (72.8%) at stage II (p > 05). At stage IB2, only 4/8 adenocarcinomas (50%) had these results versus 8/11 (72.7%) squamous cell carcinomas (p > 05). At stage II, the figures were 8/11 for adenocarcinomas (72.7%) and 43/59 for squamous cell carcinomas (72.8%). With further surgery, the results were increased by 10.1%. Failure of established therapeutics was demonstrated in 17 patients (19.3%): 4 cases due to locoregional progression (23.5%) and 13 (76.4%) due to distant dissemination. Conclusions: The results for stage IB2 were inferior to those for stages II, with most failures being related to distant metastasis. To prevent early menopause, exploring the use of neoadjuvant chemotherapy plus radical hysterectomy is recommended in younger patients. (creativecommons.org/ licenses/by-nc-nd/4.0/).