Article Text

Download PDFPDF
EP1218 Outcome in 186 patients with cervical cancer stage IB1 treated with radical hysterectomy without adjuvant radiochemotherapy, unless presenting with metastatic lymph nodes
  1. J Haesen1,
  2. R Salihi1,
  3. A-S Van Rompuy2,
  4. E Van Nieuwenhuysen1,
  5. M Christiaens3,
  6. T Van Gorp1,
  7. S Han1,
  8. P Neven1 and
  9. I Vergote1
  1. 1Division of Gynaecological Oncology, Department of Gynaecology and Obstetrics
  2. 2Department of Pathology
  3. 3Department of Radiotherapy-Oncology, University Hospitals Leuven, Leuven, Belgium


Introduction/Background Lymphovascular space invasion (LVSI), deep stromal invasion (DSI) and large tumor size have been identified as predictors for intermediate risk for recurrence. Adjuvant radiotherapy (RT) has been advocated in these patients (Sedlis Gynecol Oncol 1999,73:177). However, it is still controversial whether adjuvant radiochemotherapy (RCT) improves overall survival (OS).

Methodology All consecutive patients (1997–2017) with cervical cancer FIGO (2009) stage IB1 (≤ 4cm) treated in our department were included. Intermediate risk for recurrence was defined as presence of two of the following factors in patients with negative lymph nodes: LVSI, DSI (>10 mm) and large tumor size (>2cm).

Results Two hundred-and-one patients were included into the study, of which 186 patients underwent primary surgery and 15 patients received a fertility sparing treatment (table 1). Mean time of follow-up was 11 years (IQR 6–15). Postoperatively, 24 patients received adjuvant therapy due to presence of positive lymph nodes, positive section margins or vaginal intra-epithelial neoplasia: RCT (n=16), RT (n=7) or chemotherapy (n=1). None of the patients with intermediate risk factors according underwent adjuvant RT/RCT. Disease recurrence was observed in 23 patients (11%). The recurrences were local (n=14), distant (n=2) or both local and distant (n=7). Ten patients died of disease. The 5-year OS was 93% and the 5-year progression-free-survival (PFS) was 89%. Cox proportional hazards models showed that intermediate risk factors did not significantly influence OS or PFS.

Conclusion Recurrence rate was rather low (11%), despite the fact that only 12% of the patients with cervix cancer stage IB1 received postoperative radio(chemo)therapy. Intermediate risk factors such as LVSI, DSI (>10 mm) or tumor size >2 cm did not predict recurrence nor survival. Future studies are needed to elucidate whether adjuvant radiotherapy is needed in the current era with better survival than in the nineties when the GOG99 (Sedlis et al.) was performed.

Disclosure Nothing to disclose.

Abstract EP1218 Table 1

Patient characteristics in cervical cancer IB1 (FIGO 2009)

Abstract EP1218 Table 2

Tumor characteristics

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.