Article Text
Abstract
Introduction/Background The aim of this study is to evaluate the efficacy of adjuvant chemotherapy following radical hysterectomy (RH) for women with intermediate risk stage IB-IIA cervical cancer.
Methodology From January 2001 to December 2015, a total of 97 patients of FIGO stage IB-IIA cervical cancer having intermediate risk after radical hysterectomy and pelvic lymphadenectomy were enrolled in this study. Among these patients, 21 patients underwent adjuvant radiotherapy (RH+RT, N=21), 24 patients had cisplatin-based adjuvant chemotherapy (RH+CT, N=24), and 52 patients had surgery only (RH only, N=52). Disease-free survival (DFS) and overall survival (OS) were evaluated with Kaplan-Meier method and the log-rank test. Cox´s proportional-hazards regression model were used to evaluate the impact of prognostic factors in multivariant analysis.
Results The percentage of histology distribution in 97 patients were 70.1% (68 patients) squamous cell carcinoma and 29.9% (29 patients) non-squamous cell carcinoma. The mean 5-year DFS rate is 88.1% in RH only group, 82.6% in RH+CT group and 70.8% in RH+RT group (P=0.350), respectively. The 5-year OS rate is 95.8% in RH only group, 91.3% in RH+CT group and 85.4% in RH+RT group (P=0.343), respectively. In the univariant analysis, histologic type seemed to be a prognostic factor for recurrence (P=0.014); however, it only showed borderline significance in multivariant analysis (P=0.053).
Conclusion Concerning the long-term and irreversible toxicities related to adjuvant radiotherapy following RH, cisplatin-based adjuvant chemotherapy or close surveillance for patients with intermediate-risk cervical cancer after RH showed non-inferior survival impact as compared to adjuvant radiotherapy. Therefore, adjuvant chemotherapy or close surveillance can be an alternative management for patients having intermediate risk of recurrence following radical surgery.
Disclosure Nothing to disclose.