High-risk group for locoregional recurrence in patients with stage IB-IIB squamous cell carcinoma of the cervix treated with concurrent chemoradiotherapy.

AIM

To identify predictive factors for locoregional recurrence in patients with FIGO stage IB-IIB cervical cancer treated with concurrent chemoradiotherapy (CCRT).

PATIENTS AND METHODS

Data were analyzed for 123 patients with FIGO stage IB-IIB squamous cell carcinoma of the cervix between 1997 and 2007. Eligibility for CCRT included tumor size >4 cm and/or lymph node enlargement over a minimum diameter of 1 cm.

RESULTS

Tumor size (≥5.2 cm) and age (<48 years) were independent predictive factors for locoregional recurrence by multivariate analysis. Based on these two factors, the patients were divided into low-risk (n=91) and high-risk (n=32) groups for locoregional recurrence. The 5-year disease-free survival for the low-risk group was 95.3%, which was significantly better than 65.5% for the high-risk group (p<0.0001). Locoregional recurrence was noted in 10 out of the 32 patients in the high-risk group compared to only 3 out of the 91 patients in the low-risk group.

CONCLUSION

To improve locoregional control in the high-risk group, it may be worthwhile to consider CCRT using new radiosensitizing agents, adjuvant hysterectomy or adjuvant chemotherapy.