JCT  Vol.6 No.12 , November 2015
Treatment Results of Adjuvant Chemotherapy after Radical Hysterectomy for Intermediate-Risk Stage IB-IIB Cervical Cancer
ABSTRACT
Objective: The objective is to evaluate the effectiveness of chemotherapy as postoperative adjuvant therapy for stage IB-IIB cervical cancer with intermediate-risk factors. Methods: We retrospectively reviewed the medical records of 119 cervical cancer patients with intermediate-risk factors treated with radical hysterectomy and pelvic lymphadenectomy from December 1997 to September 2010. The intermediate-risk factors included bulky tumor (≥4 cm), lymphovascular space invasion, and deep stromal invasion. Sixteen patients did not receive adjuvant therapy (observation group); 73 were treated with chemotherapy (CT group); 30 were treated with adjuvant radiation therapy (RT group). The significance of the clinical parameters, 3- and 5-year overall survival (OS) rates of each group, was analyzed. Results: The 3- and 5-year OS rates between the observation group and adjuvant therapy group (CT plus RT groups) were not statistically different (3-year OS: 100% and 94.4%, respectively; 5-year OS: 100% and 92.3%, respectively; p > 0.05). The 3- and 5-year OS rates between the CT group and RT group were also not statistically different (3-year OS: 93.6% and 96.4%, respectively; 5-year OS: 80.7% and 96.4%, respectively; p < 0.05). Univariate and multivariate analysis of survival indicated that different adjuvant therapies were not independent prognostic indicators for IB-IIB cervical cancer patients with intermediate-risk factors. Conclusions: CT may have equivalent therapeutic effect as RT for stage IB-IIB cervical cancer patients with intermediate-risk factors after radical surgery, and prospective randomized trial is needed to study the effect of CT in these patients.

Cite this paper
Wen, H. , Liu, T. , Feng, Z. , Huang, W. , Ma, K. and Tao, X. (2015) Treatment Results of Adjuvant Chemotherapy after Radical Hysterectomy for Intermediate-Risk Stage IB-IIB Cervical Cancer. Journal of Cancer Therapy, 6, 1075-1082. doi: 10.4236/jct.2015.612117.
References
[1]   Nam, J.H., Park, J.Y., Kim, D.Y., et al. (2012) Laparoscopic versus Open Radical Hysterectomy in Early-Stage Cervical Cancer: Long-Term Survival Outcomes in a Matched Cohort Study. Annals of Oncology, 23, 903-911.
http://dx.doi.org/10.1093/annonc/mdr360

[2]   Park, J.Y., Kim, D.Y., Kim, J.H., et al. (2011) Outcomes after Radical Hysterectomy According to Tumor Size Divided by 2-cm Interval in Patients with Early Cervical Cancer. Annals of Oncology, 22, 59-67.
http://dx.doi.org/10.1093/annonc/mdq321

[3]   Song, S., Song, C., Kim, H.J., et al. (2012) 20-Year Experience of Postoperative Radiotherapy in IB-IIA Cervical Cancer Patients with Intermediate Risk Factors: Impact of Treatment Period and Concurrent Chemotherapy. Gynecologic Oncology, 124, 63-67.
http://dx.doi.org/10.1016/j.ygyno.2011.09.033

[4]   Garg, G., Shah, J.P., Toy, E.P., et al. (2011) Stage IIA1 versus Stage IIA2 Cervical Cancer: Does the New Staging Criteria Predict Survival? International Journal of Gynecological Cancer, 21, 711-716.
http://dx.doi.org/10.1097/IGC.0b013e3182138648

[5]   Peters, W.A., Liu, P.Y., Barrett, R.J., et al. (2000) Concurrent Chemotherapy and Pelvic Radiation Therapy Compared with Pelvic Radiation Therapy Alone as Adjuvant Therapy after Radical Surgery in High-Risk Early-Stage Cancer of the Cervix. Journal of Clinical Oncology, 18, 1606-1613.
http://dx.doi.org/10.1097/00006254-200008000-00017

[6]   Lahousen, M., Haas, J., Pickel, H., et al. (1999) Chemotherapy versus Radiotherapy versus Observation for High-Risk Cervical Carcinoma after Radical Hysterectomy: A Randomized, Prospective, Multicenter Trial. Gynecologic Oncology, 73, 196-201.
http://dx.doi.org/10.1006/gyno.1999.5343

[7]   Curtin, J.P., Hoskins, W.J., Venkatraman, E.S., et al. (1996) Adjuvant Chemotherapy versus Chemotherapy plus Pelvic Irradiation for High-Risk Cervical Cancer Patients after Radical Hysterectomy and Pelvic Lymphadenectomy (RH-PLND): A Randomized Phase III Trial. Gynecologic Oncology, 61, 3-10.
http://dx.doi.org/10.1006/gyno.1996.0087

[8]   Iwasaka, T., Kamura, T., Yokoyama, M., et al. (1998) Adjuvant Chemotherapy after Radical Hysterectomy for Cervical Carcinoma: A Comparison with Effects of Adjuvant Radiotherapy. Obstetrics & Gynecology, 91, 977-981.
http://dx.doi.org/10.1016/S0029-7844(98)00079-9

[9]   Takeshima, N., Umayahara, K., Fujiwara, K., et al. (2006) Treatment Results of Adjuvant Chemotherapy after Radical Hysterectomy for Intermediate- and High-Risk Stage IB-IIA Cervical Cancer. Gynecologic Oncology, 103, 618-622.
http://dx.doi.org/10.1016/j.ygyno.2006.04.019

[10]   Hosaka, M., Watari, H., Takeda, M., et al. (2008) Treatment of Cervical Cancer with Adjuvant Chemotherapy versus Adjuvant Radiotherapy after Radical Hysterectomy and Systematic Lymphadenectomy. The Journal of Obstetrics and Gynaecology Research, 34, 552-556.
http://dx.doi.org/10.1111/j.1447-0756.2008.00739.x

[11]   Lee, K.B., Lee, J.M., Ki, K.D., et al. (2008) Comparison of Adjuvant Chemotherapy and Radiation in Patients with Intermediate Risk Factors after Radical Surgery in FIGO Stage IB-IIA Cervical Cancer. International Journal of Gynecological Cancer, 18, 1027-1031.
http://dx.doi.org/10.1111/j.1525-1438.2007.01136.x

 
 
Top