Adjuvant Chemotherapy Without Radiation Effective in Stage IB-IIA Cervical Cancer

Adjuvant chemotherapy without radiation resulted in high disease-free survival (DFS) and overall survival (OS) rates among patients with known risk factors and International Federation of Gynecology and Obstetrics (FIGO) stage IB to IIA cervical cancer, according to a study presented at the 2017 Society of Gynecologic Oncology Annual Meeting.¹

This retrospective, consecutive series included 101 treatment-naive patients from South Korea with FIGO stage IB to IIA cervical cancer who underwent type C2 radical hysterectomy and pelvic lymph node dissection with or without para-aortic lymph node dissection. Patients with at least 1 lymph node metastasis and/or a combination of 3 risk factors including lymphovascular space invasion, depth of stroma invasion, and tumor size were treated with adjuvant chemotherapy consisting of platinum alone or a platinum-based regimen.

At baseline, the mean age was 47.1 and 33.7% of women were menopausal. Cervical tumor histologies included squamous (74.3%), adenocarcinoma (14.9%), adenosquamous (5.9%), and other (4.9%). Seventy-six patients had a combination of the 3 risk factors without lymph node metastasis and 25 had at least 1 metastatic lymph node. Disease recurrence occurred in 14 of the 101 patients.

During a median follow-up time of 65 months, the 3-year DFS was 90.7%, 5-year OS was 90.6%, and the 5-year cervical cancer–specific OS was 94.7% in the overall population. Among patients with a combination of the 3 risk factors, the 3-year DFS was 94.6%, 5-year OS was 90.6%, and cervical cancer–specific OS was 96.2%. These rates decreased among patients with lymph node metastasis to a 3-year DFS of 79.4%, 5-year OS of 90.6%, and cervical cancer–specific OS of 90.6%.

These data suggest that adjuvant chemotherapy without radiation may be an effective option for patients with stage IB to IIA cervical cancer with risk factors.

Reference

1. Lee KB, Lee JM, Kim YS. Oncologic outcomes of adjuvant chemotherapy in patients with risk factors after radical surgery in FIGO stage IB-IIA cervical cancer. Paper presented at: 48^th Annual Meeting of the Society of Gynecologic Oncology; March 12-15, 2017; National Harbor, MD.