Prognosis Of Stage â…  B-â…¡A Squamous Cell Cervical Cancer With Intermediate Risk Factors Treated By Adjuvant Chemotherapy Or Radiotherapy:a Comparative Study

Objective:The aim of this retrospective study is to evaluate the efficacy of adjuvant chemotherapy following radical hysterectomy for intermediate risk stage Ⅰ b-Ⅱ a squamous cell cervical cancer.Methods:From January 2010 to December 2014, a total of 143 patients of stage Ⅰ b-Ⅱ a were enrolled in this study who had at least one of the following three intermediate risk factors (stromal invasion> 1/3, lymphovascular space involvement, primary tumor≥ 4 cm in size) after radical hysterectomy and all patients had no high risk factors. Of these patients,57patients had adjuvant chemotherapy, and 86 patients had adjuvant radiotherapy with or without concurrent chemotherapy. Independent prognostic factors affecting RFS were assessed by Cox’s proportional-hazards regression model.Result:After a median follow up of 36.6 months (range,14-63 months), of the 143 patients,4 developed metastasis (2 in the chemotherapy group,2 in the radiotherapy group), and 4 deaths in radiotherapy group. RFS was not significantly different for tumor size, depth of invasion, LVSI and adjuvant therapy.Conclusion:There are equivalent therapeutic results between chemotherapy and radiotherapy or chemo-radiation for patients with intermediate risk factors after radical surgery. Adjuvant chemotherapy may be one choice of postoperative adjuvant therapy for stage Ⅰ b-Ⅱ a cervical cancer with intermediate risk factors.Objectives:To evaluate the effectiveness of adjuvant therapies (radiotherapy, chemotherapy, chemo-radiation) after radical hysterectomy for early-stage cervical cancer (FIGO stage Ⅰ b1、Ⅰ b2 or Ⅱ a) with intermediate risk factorsMethods:Reviewing the literatures of adjuvant therapies following radical hysterectomy for intermediate risk cervical cancer in databases, such as Pubmed, EMbase, The Cochrane Library and CNKI. We use a double-abstraction process whereby two independent assessments of each study can be compared and reconciled if necessary. The meta-analysis was performed using the Review Manager (RevMan) software, version 5.3, and the R software, version 3.2.0.Main results:Three case-control studies, which compared adjuvant chemotherapy with adjuvant radiotherapy, met inclusion criteria. They assessed 203 women with intermediate risk factors. Meta-analysis of these studies indicated no significant difference in RFS of 3 years between women who received adjuvant radiation and those who receive adjuvant chemotherapy (OR=1.02,95%CI0.27 to 3.81)Conclusion:There are equivalent therapeutic results between chemotherapy and combined chemo-radiation for patients with intermediate risk factors after radical surgery. Adjuvant chemotherapy may be one choice of postoperative adjuvant therapy for stage Ⅰ b-Ⅱ a cervical cancer with intermediate risk factors.