Introduction/Background In intermediate-risk cervical cancer (CC), the indication for postoperative radiation therapy (RT) is based on a combination of three histological risk factors: lympho-vascular space invasion (LVSI), depth of stromal invasion, and tumour diameter, the so called ‘Sedlis criteria’. However, despite their previous validation, it is well known the high variability on the management of adjuvant therapy between different institutions.

Methodology A retrospective analysis was performed using the SUCCOR study database to investigate surgically staged intermediate-risk patients. Patients with FIGO stage 2018 IB1 and IB2 at final pathology were included in the present study. Univariate and multivariable analyses were performed to determine on which factors the recommendation of adjuvant radiation therapy was based on.

Results The study population consisted of 572 patients; 13.2% of patients not receiving RT had positive Sedlis criteria and 56.9% of patients undergoing RT had negative criteria. Patients with tumours larger than 2 cm had a greater likelihood of receiving adjuvant RT (OR 1.7, p 0.04), while those with LVSI had twice the likelihood of undergoing postoperative treatment (OR 2.05, p 0.004). Furthermore, the probability of receiving adjuvant RT was 5 times higher (OR 5.11, p <0.001) for patients with deep stromal invasion, and almost 2 times higher (OR 1.97, p 0.02) for patients with intermediate stromal invasion in comparison to those with superficial stromal invasion.

Conclusion Whilst the Sedlis criteria ought to govern the decision to administer postoperative RT, healthcare providers do not always adhere to this indication. Tumour diameter, LVSI, and depth of invasion were all found to be significantly associated with the administration of adjuvant RT; however, we observed a significant variety in the postoperative adjuvant management among the institutions involved in the SUCCOR study. A call for standardized recommendation of adjuvant radiation therapy is needed.

Disclosures none