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Original Research

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The prognosis of high-risk early-stage cervical cancer patients who did not receive postoperative concurrent chemoradiotherapy

  • H. Kuroda1
  • S. Mabuchi1,*,
  • Y. Matsumoto1
  • K. Kozasa1
  • T. Sasano1
  • R. Takahashi1
  • E. Kobayashi1
  • T. Kimura1

1Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka (Japan)

DOI: 10.12892/ejgo3860.2018 Vol.39,Issue 2,April 2018 pp.225-230

Published: 10 April 2018

*Corresponding Author(s): S. Mabuchi E-mail: smabuchi@gyne.med.osaka-u.ac.jp

Abstract

Purpose of investigation. To investigate the prognosis of high-risk early-stage cervical cancer patients who did not receive postoperative concurrent chemoradiotherapy (CCRT). Materials and Methods. The characteristics and outcomes of high-risk early-stage cervical cancer patients who did not receive postoperative CCRT were collected. They were separated into two groups according to the type of adjuvant treatment: no further therapy (NFT group) or chemotherapy (chemotherapy group), and the clinico-pathological characteristics, recurrence rate, progression-free survival (PFS), and overall survival (OS) were investigated. Results. A total of 23 patients were included. After a median follow-up period of 115 months, 19 had developed recurrent disease, and 17 had died of disease progression. The median PFS and OS of all patients were ten and 29 months, respectively. The recurrence rate of the NFT group (n=10) was similar to that of the chemotherapy group (n=13) (80% vs. 85%, p > 0.05). Although the PFS and OS of the chemotherapy group were slightly longer than those of the NFT group, the differences were not statistically significant (PFS, 10 vs. 36 months, p > 0.05; OS, 28 vs. 59 months p > 0.05). Conclusion. High-risk early-stage cervical cancer patients who did not receive postoperative CCRT have dismal prognosis irrespective of the type of adjuvant treatment.

Keywords

Survival; Cervical cancer; Radical hysterectomy; Adjuvant treatment; High-risk group.

Cite and Share

H. Kuroda,S. Mabuchi,Y. Matsumoto,K. Kozasa,T. Sasano,R. Takahashi,E. Kobayashi,T. Kimura. The prognosis of high-risk early-stage cervical cancer patients who did not receive postoperative concurrent chemoradiotherapy. European Journal of Gynaecological Oncology. 2018. 39(2);225-230.

References

[1] Landoni F., Maneo A., Colombo A., Placa F., Milani R., Perego P., et al.: “Randomised study of radical surgery versus radiotherapy for stage Ib-IIa cervical cancer” Lancet, 1997, 350, 535.

[2] Morley G.W., Seski J.C.: “Radical pelvic surgery versus radiation therapy for stage I carcinoma of the cervix (exclusive of microinvasion)”. Am. J. Obstet. Gynecol., 1976, 126, 785.

[3] Perez C.A., Camel H.M., Kao M.S., Hederman M.A.: “Randomized study of preoperative radiation and surgery or irradiation alone in the treatment of stage IB and IIA carcinoma of the uterine cervix: final report”. Gynecol. Oncol., 1987, 27, 129.

[4] Benedet J.L., Odicino F., Maisonneuve P., Beller U., Creasman W.T., Heintz A.P., et al.: “Carcinoma of the cervix uteri”. Int. J. Gynaecol. Obstet., 2003, 83, 41.

[5] Kasamatsu T., Onda T., Sawada M., Kato T., Ikeda S.: “Radical hysterectomy for FIGO stage IIB cervical cancer: clinicopathological characteristics and prognostic evaluation”. Gynecol. Oncol., 2009, 114, 69.

[6] Delgado G., Bundy B., Zaino R., Sevin B.U., Creasman W.T., Major F.: “Prospective surgical-pathological study of disease-free interval in patients with stage IB squamous cell carcinoma of the cervix: a Gynecologic Oncology Group study”. Gynecol. Oncol., 1990, 38, 352.

[7] Fuller A.F. Jr., Elliott N., Kosloff C., Hoskins W.J., Lewis J.L. Jr.: “Determinants of increased risk for recurrence in patients undergoing radical hysterectomy for stage IB and IIA carcinoma of the cervix”. Gynecol. Oncol., 1989, 33, 34.

[8] Samlal R.A., van der Velden J., Schilthuis M.S., Gonzalez Gonzalez D., Ten Kate F.J., Hart A.A., et al.: “Identification of high-risk groups among node-positive patients with stage IB and IIA cervical carcinoma”. Gynecol. Oncol., 1997, 64, 463.

[9] Kim K., Kang S.B., Chung H.H., Kim J.W., Park N.H., Song Y.S.: “Comparison of chemoradiation with radiation as postoperative adjuvant therapy in cervical cancer patients with intermediate-risk factors”. Eur. J. Surg. Oncol., 2009, 35, 192.

[10] Ryu S.Y., Park S.I., Nam B.H., Cho C.K., Kim K., Kim B.J., et al.: “Is adjuvant chemoradiotherapy overtreatment in cervical cancer patients with intermediate risk factors?” Int. J. Radiat. Oncol. Biol. Phys., 2011, 79, 794.

[11] Song S., Song C., Kim H.J., Wu H.G., Kim J.H., Park N.H., et al.: “20 year experience of postoperative radiotherapy in IB-IIA cervical cancer patients with intermediate risk factors: impact of treatment period and concurrent chemotherapy”. Gynecol. Oncol., 2012, 124, 63.

[12] Rotman M., Sedlis A., Piedmonte M.R., Bundy B., Lentz S.S., Muderspach L.I., et al.: “A phase III randomized trial of postoperative pelvic irradiation in Stage IB cervical carcinoma with poor prognostic features: follow-up of a gynecologic oncology group study”. Int. J. Radiat. Oncol. Biol. Phys., 2006, 65, 169.

[13] Sedlis A., Bundy B.N., Rotman M.Z., Lentz S.S., Muderspach L.I., Zaino R.J.: “A randomized trial of pelvic radiation therapy versus no further therapy in selected patients with stage IB carcinoma of the cervix after radical hysterectomy and pelvic lymphadenectomy: A Gynecologic Oncology Group Study”. Gynecol. Oncol., 1999, 73, 177.

[14] NCT01101451. National Cancer Institute: “Radiation Therapy With or Without Chemotherapy in Patients With Stage I or Stage II Cervical Cancer Who Previously Underwent Surgery”. Available at: www.cancer.gov/clinicaltrials/search/view?cdrid=670125&version=Heal thProfessional&protocolsearchid=10780359

[15] Peters W.A. 3rd., Liu P.Y., Barrett R.J. 2nd., Stock R.J., Monk B.J., Berek J.S., et al.: “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”. J. Clin. Oncol., 2000, 18, 1606.

[16] Mabuchi S., Okazawa M., Isohashi F., Matsuo K., Ohta Y., Suzuki O., et al.: “Radical hysterectomy with adjuvant radiotherapy versus definitive radiotherapy alone for FIGO stage IIB cervical cancer”. Gynecol. Oncol., 2011, 123, 241.

[17] Mabuchi S., Okazawa M., Matsuo K., Kawano M., Suzuki O., Miyatake T., et al.: “Impact of histological subtype on survival of patients with surgically-treated stage IA2-IIB cervical cancer: Adenocarcinoma versus squamous cell carcinoma”. Gynecol. Oncol., 2012, 127, 114.

[18] Isohashi F., Mabuchi S., Yoshioka Y., Seo Y., Suzuki O., Tamari K., et al.: “Intensity-modulated radiation therapy versus three-dimensional conformal radiation therapy with concurrent nedaplatin-based chemotherapy after radical hysterectomy for uterine cervical cancer: comparison of outcomes, complications, and dose-volume histogram parameters”. Radiat. Oncol., 2015, 10, 180.

[19] Okazawa M., Mabuchi S., Isohashi F., Suzuki O., Yoshioka Y., Sasano T., et al.: “Impact of the addition of concurrent chemotherapy to pelvic radiotherapy in surgically treated stage IB1-IIB cervical cancer patients with intermediate-risk or high-risk factors: a 13-year experience”. Int. J. Gynecol. Cancer, 2013, 23, 567.

[20] Mabuchi S., Morishige K., Isohashi F., Yoshioka Y., Takeda T., Yamamoto T., et al.: “Postoperative concurrent nedaplatin-based chemoradiotherapy improves survival in early-stage cervical cancer patients with adverse risk factors”. Gynecol. Oncol., 2009, 115, 482.

[21] Mabuchi S., Isohashi F., Maruoka S., Hisamatsu T., Takiuchi T., Yoshioka Y., Kimura T.: “Post-treatment follow-up procedures in cervical cancer patients previously treated with radiotherapy”. Arch. Gynecol. Obstet., 2012, 286, 179.

[22] Mabuchi S., Isohashi F., Yoshioka Y., Temma K., Takeda T., Yamamoto T., et al.: “Prognostic factors for survival in patients with recurrent cervical cancer previously treated with radiotherapy”. Int. J. Gynecol. Cancer, 2010, 20, 834.

[23] Mabuchi S., Takahashi R., Isohashi F., Yokoi T., Okazawa M., Sasano T., Maruoka S., et al.: “Reirradiation using high-dose-rate interstitial brachytherapy for locally recurrent cervical cancer: a single institutional experience”. Int. J. Gynecol. Cancer, 2014, 24, 141.

[24] Hisamatsu T., Mabuchi S., Yoshino K., Fujita M., Enomoto T., Hamasaki T., Kimura T.: “Prediction of progression-free survival and response to paclitaxel plus carboplatin in patients with recurrent or advanced cervical cancer”. Int. J. Gynecol. Cancer, 2012, 22, 623.

[25] Jung P.S., Kim D.Y., Lee S.W., Park J.Y., Suh D.S., Kim J.H.: “Clinical Role of Adjuvant Chemotherapy after Radical Hysterectomy for FIGO Stage IB-IIA Cervical Cancer: Comparison with Adjuvant RT/CCRT Using Inverse-Probability-of-Treatment Weighting”. PLoS One, 2015, 10, e0132298.

[26] Takeshima N., Utsugi K., Hasumi K., Takizawa K.: “Postoperative adjuvant chemotherapy for node-positive cervical adenocarcinoma”. Int. J. Gynecol. Cancer, 2009, 19, 277.

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