Department of Obstetrics and Gynecology, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea.
Division of Hematology and Oncology, Department of Internal Medicine, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea.
J Gynecol Oncol. 2018 Jan;29(1):e5. doi: 10.3802/jgo.2018.29.e5.
To evaluate the oncologic outcomes of adjuvant chemotherapy (CT) alone after radical surgery.
We retrospectively reviewed the medical records of patients who underwent type C radical hysterectomy and pelvic lymphadenectomy with or without paraaortic lymphadenectomy for stage IB-IIA cervical cancer from March 2006 to December 2014 at 2 academic medical centers in Korea. Adjuvant CT alone for patients who met the Sedlis criteria or had lymph node (LN) involvement. Chemotherapeutic regimens consisted of either platinum alone or platinum-based combination.
A total of 101 consecutive patients were included in the analysis. The median age was 46.0 years (range, 23-73). Seventy-four patients (73.3%) were clinically staged as IB1; 23 and 4 patients as IB2 and IIA, respectively. The median number of retrieved pelvic and paraaortic LNs (PALNs) were 55.0 (range, 16-101) and 10.0 (range, 2-30), respectively. LN involvement was observed in 25 patients (24.8%). After the median follow-up of 65 months, 14 patients (13.9%) developed disease recurrence. In all patients, the estimated 3-year disease-free survival (DFS) rate and 5-year overall survival (OS) rate were 90.7% and 90.6%, respectively. In patients who met the Sedlis criteria, the 3-year DFS and 5-year OS rates were 94.6% and 90.6%, respectively. Patients with LN metastasis showed a 3-year DFS rate of 79.4% and a 5-year OS rate of 90.6%.
Adjuvant CT alone could be reasonable option for patients with surgical-pathologic risk factors after radical surgery in stage IB-IIA cervical cancer.
评估根治性手术后辅助化疗（CT）的肿瘤学结局。
我们回顾性分析了 2006 年 3 月至 2014 年 12 月在韩国 2 所学术医疗中心接受 C 型根治性子宫切除术和盆腔淋巴结切除术（伴或不伴腹主动脉旁淋巴结切除术）的 IB-IIA 期宫颈癌患者的病历。符合 Sedlis 标准或有淋巴结（LN）受累的患者采用辅助 CT 治疗。化疗方案包括铂类单药或铂类联合方案。
共纳入 101 例连续患者进行分析。中位年龄为 46.0 岁（范围 23-73 岁）。74 例（73.3%）为临床分期 IB1 期；23 例和 4 例分别为 IB2 期和 IIA 期。盆腔和腹主动脉旁淋巴结（PALN）的中位检出数分别为 55.0（范围 16-101）和 10.0（范围 2-30）。25 例（24.8%）患者存在 LN 受累。中位随访 65 个月后，14 例（13.9%）患者出现疾病复发。在所有患者中，估计 3 年无病生存率（DFS）和 5 年总生存率（OS）分别为 90.7%和 90.6%。符合 Sedlis 标准的患者 3 年 DFS 率和 5 年 OS 率分别为 94.6%和 90.6%。有 LN 转移的患者 3 年 DFS 率为 79.4%，5 年 OS 率为 90.6%。
对于 IB-IIA 期宫颈癌根治性手术后具有手术病理危险因素的患者，单独辅助 CT 可能是合理的选择。
