Obstet Gynecol Sci.  2013 Jan;56(1):15-21. 10.5468/OGS.2013.56.1.15.

Promising treatment results of adjuvant chemotherapy following radical hysterectomy for intermediate risk stage 1B cervical cancer

• Lee TY
• Jeung YJ
• Lee CJ
• Kim HY
• Kim SH
• Kim WG

• KMID: 1857181
• DOI: http://doi.org/10.5468/OGS.2013.56.1.15

Abstract

OBJECTIVE
The aim of this retrospective study is to evaluate the efficacy of adjuvant chemotherapy following radical hysterectomy for intermediate risk stage IB cervical cancer.
METHODS
From January 1993 to December 2007, a total of 100 patients of stage IB were enrolled in this study who had at least two of the following three intermediate risk factors (deep stromal invasion, lymphovascular space involvement, and large tumor size) after radical hysterectomy and all patients had no high risk factors and no radiotherapy. Of these patients, 22 patients had surgery only and 78 patients had cisplatin-based combination chemotherapy as adjuvant therapy postoperatively to improve survival. Kaplan-Meier survival curves and Cox's proportional-hazards regression model and log-rank test were used for survival analysis and to estimate the impact of prognostic factors on survival.
RESULTS
The mean age was 52 years (range, 28 to 76 years). The overall survival rate of all intermediate tumors are 92% (92/100). Surgery only group is 81.8% (18/22) and adjuvant chemotherapy group is 94.9% (74/78). Comparison of survival between two groups revealed significant statistical difference in both univariant and multivariant survival analysis (P<0.05). The main toxicities of adjuvant chemotherapy were bone marrow suppression (18%), nausea and vomiting (5.2%) and alopecia in etoposide-cisplatin chemotherapy group (100%) but most side effects of postoperative adjuvant chemotherapy were transient, reversible and within acceptable limits to all patients.
CONCLUSION
Cisplatin based combined adjuvant chemotherapy for intermediate risk tumors after radical hysterectomy is promising with significant improvement of overall survival and with acceptable toxicity profile.

Keyword

Uterine cervical neoplasm; Chemotherapy, Adjuvant; Cisplatin; Survival analysis

MeSH Terms

Alopecia
Bone Marrow
Chemotherapy, Adjuvant
Cisplatin
Drug Therapy, Combination
Humans
Hysterectomy
Kaplan-Meier Estimate
Nausea
Retrospective Studies
Risk Factors
Survival Analysis
Survival Rate
Uterine Cervical Neoplasms
Vomiting
Cisplatin

Figure

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  Fig. 1 Overall survival by treatment type.

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