Effectiveness of adjuvant systemic chemotherapy for intermediaterisk stage IB cervical cancer

Koji Matsuo, Muneaki Shimada, Harushige Yokota, Toyomi Satoh, Hidetaka Katabuchi, Shoji Kodama, Hiroshi Sasaki, Noriomi Matsumura, Mikio Mikami, Toru Sugiyama

Research output: Contribution to journalArticlepeer-review

19 Citations (Scopus)

Abstract

Objective: To examine the effectiveness of systemic chemotherapy following radical hysterectomy for women with intermediate-risk stage IB cervical cancer. Materials and Methods: This is a retrospective analysis of a previously organized nation-wide cohort study examining 6,003 women with stage IB-IIB cervical cancer who underwent radical hysterectomy between 2004 and 2008 in Japan. Survival of 555 women with stage IB cervical cancer in the intermediate-risk group (deep stromal invasion > 50%, large tumor size > 4 cm, and lympho-vascular space invasion [LVSI]) were examined based on adjuvant therapy patterns: chemotherapy alone (n = 223, 40.2%), concurrent chemo-radiotherapy (n = 172, 31.0%), and radiotherapy alone (n = 160, 28.8%). Results: The most common intermediate-risk pattern was LVSI with deep stromal invasion (n = 216, 38.5%). The most common chemotherapeutic choice was taxane/ platinum (52.2%). Women with adenocarcinoma/adenosquamous histology were more likely to receive chemotherapy (P = 0.03), and intermediate-risk pattern was not associated with chemotherapy use (P = 0.11). Women who received systemic chemotherapy had disease-free survival (5-year rate, 88.1% versus 90.2%, adjustedhazard ratio (HR) 0.98, 95% confidence interval (CI) 0.52-1.83, P = 0.94) and cause-specific survival (95.4% versus 94.8%, adjusted-HR 0.85, 95% CI 0.34-2.07, P = 0.71) similar to those who received concurrent chemo-radiotherapy on multivariable analysis. Similar results were seen among 329 women with multiple intermediaterisk factors (5-year rates for disease-free survival, chemotherapy versus concurrent chemo-radiotherapy, 87.1% versus 90.2%, P = 0.86; and cause-specific survival 94.6% versus 93.4%, P = 0.82). Cumulative local-recurrence (P = 0.77) and distantrecurrence (P = 0.94) risks were similar across the adjuvant therapy types. Conclusions: Our study suggests that systemic chemotherapy may be an alternative treatment choice for adjuvant therapy in intermediate-risk stage IB cervical cancer.

Original languageEnglish
Pages (from-to)106866-106875
Number of pages10
JournalOncotarget
Volume8
Issue number63
DOIs
Publication statusPublished - 2017

Keywords

  • Adjuvant
  • Cervical cancer
  • Chemotherapy
  • Intermediate risk
  • Radical hysterectomy

ASJC Scopus subject areas

  • Oncology

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