Radiat Oncol J.  2017 Mar;35(1):39-47. 10.3857/roj.2016.01893.

Clinical outcomes in patients treated with radiotherapy after surgery for cervical cancer

• Yang K
• Park W
• Huh SJ
• Bae DS
• Kim BG
• Lee JW

• KMID: 2401798
• DOI: http://doi.org/10.3857/roj.2016.01893

Abstract

PURPOSE
The purpose of this study was to analyze clinical outcomes from cervical cancer and stratify patients into risk groups for prognostic factors for early-stage disease.
MATERIALS AND METHODS
We retrospectively reviewed patients with stage IB or IIA cervical cancer treated with adjuvant radiotherapy (RT) or concurrent chemoradiotherapy (CCRT) following primary surgery at Samsung Medical Center from 2001 to 2011. Adjuvant RT was added for patients with intermediate-risk factors, and adjuvant CCRT was performed on high-risk patients after surgery.
RESULTS
We reviewed 247 patients"”149 in the high-risk group and 98 in intermediate-risk group. The median follow-up was 62 months. Loco-regional failure (LRF) alone occurred in 7 patients (2.8%), distant metastasis alone in 37 patients (15.0%) and LRF with DM in 4 patients (1.6%). The 5-year disease-free survival (DFS) and overall survival (OS) rates for both groups were 79.7% and 87.6%, respectively. In the high-risk group, the 5-year DFS and OS probabilities were 72.5% and 81.9%, respectively. Histologic type, pathologic tumor size, and the number of pelvic lymph node (PLN) metastasis were significant prognostic factors for DFS and OS. We suggest a scoring system (0-3) using these prognostic factors to predict poor prognosis in high-risk patients. Using this system, patients with higher scores have higher recurrence and lower survival rates.
CONCLUSION
In the high-risk cervical-cancer group who received primary surgery and adjuvant CCRT, non-squamous type, large tumor size and the number of PLN metastasis were significant prognostic factors, and the number of these factors was associated with survival rates.

Keyword

Uterine cervical neoplasms; Hysterectomy; Adjuvant radiotherapy; Adjuvant chemoradiotherapy

MeSH Terms

Chemoradiotherapy
Chemoradiotherapy, Adjuvant
Disease-Free Survival
Follow-Up Studies
Humans
Hysterectomy
Lymph Nodes
Neoplasm Metastasis
Prognosis
Radiotherapy*
Radiotherapy, Adjuvant
Recurrence
Retrospective Studies
Survival Rate
Uterine Cervical Neoplasms*