Tokalioglu Abdurrahman Alp, Oktar Okan, Aytekin Okan, Alci Aysun, Kahraman Alper, Ege Volkan, Kilic Fatih, Ersak Burak, Celik Fatih, Koca Yildirim Hande Esra, Cakir Caner, Yuksel Dilek, Kilic Cigdem, Selcuk Ilker, Kimyon Comert Gunsu, Boran Nurettin, Basaran Derman, Ureyen Isin, Toptas Tayfun, Korkmaz Vakkas, Karalok Alper, Tasci Tolga, Moraloglu Tekin Ozlem, Ustun Yaprak, Ozgul Nejat, Turan Taner
Department of Gynaecological Oncology, Ankara Bilkent City Hospital, Faculty of Medicine, University of Health Sciences, 06800 Ankara, Turkey.
Department of Gynaecological Oncology, Ankara Etlik City Hospital, Faculty of Medicine, University of Health Sciences, 06170 Ankara, Turkey.
Oncol Lett. 2025 Apr 23;29(6):308. doi: 10.3892/ol.2025.15054. eCollection 2025 Jun.
The objective of the present study was to examine how intermediate-risk factors affect the oncological outcomes of patients diagnosed with International Federation of Gynecology and Obstetrics (FIGO) 2018 stage IB2 cervical cancer who do not undergo any adjuvant treatment. A multicentric retrospective study that involved 612 patients who were diagnosed with stage IA-IB2 cervical cancer at seven tertiary gynaecological oncology centres between 1993 and 2023 was conducted. A total of 232 patients were classified as FIGO 2018 stage IB2. Patients who had received neoadjuvant chemotherapy, parametrial or surgical border involvement, received adjuvant therapy and synchronous tumours were excluded from the present cohort. Therefore, the present study cohort consisted of 120 patients who had undergone radical hysterectomy and lymphadenectomy. Among the 120 patients, 89 (74.2%) had squamous cell cancer, 18 (15%) had adenocarcinoma, 2 (1.7%) had a mixed type tumour consisting of squamous cell cancer and adenocarcinoma and 11 (9.1%) had other types of tumours (adenosquamous cancer and glassy cell cancer). Deep cervical stromal invasion was found in 68 (56.7%) patients. The duration of patient follow-up varied from 1 to 246 months, with a median of 36 months. Overall, 6 patients (5%) experienced recurrence and 1 patient (0.8%) succumbed to the disease. The 3-year disease-free survival (DFS) rate was 94%, whereas the 3-year overall survival rate was 99%. The presence of deep cervical stromal invasion had a statistically significant impact on DFS (P=0.038). Deep cervical stromal invasion was found to be associated with recurrence in patients with stage IB2 cervical cancer. Hence, the present study demonstrated that the presence of deep cervical stromal invasion may be considered a key parameter in determining whether adjuvant treatment should be applied in patients with stage IB2 cervical cancer.
本研究的目的是探讨中度风险因素如何影响被诊断为国际妇产科联盟（FIGO）2018年IB2期宫颈癌且未接受任何辅助治疗的患者的肿瘤学结局。开展了一项多中心回顾性研究，纳入了1993年至2023年期间在7家三级妇科肿瘤中心被诊断为IA-IB2期宫颈癌的612例患者。共有232例患者被分类为FIGO 2018年IB2期。本队列排除了接受新辅助化疗、宫旁或手术切缘受累、接受辅助治疗以及合并同步肿瘤的患者。因此，本研究队列由120例行根治性子宫切除术和淋巴结清扫术的患者组成。在这120例患者中，89例（74.2%）为鳞状细胞癌，18例（15%）为腺癌，2例（1.7%）为鳞状细胞癌和腺癌组成的混合型肿瘤，11例（9.1%）为其他类型肿瘤（腺鳞癌和玻璃样细胞癌）。68例（56.7%）患者存在宫颈深部间质浸润。患者随访时间为1至246个月，中位数为36个月。总体而言，6例（5%）患者出现复发，1例（0.8%）患者死于该疾病。3年无病生存率（DFS）为94%，而3年总生存率为99%。宫颈深部间质浸润的存在对DFS有统计学显著影响（P=0.038）。宫颈深部间质浸润被发现与IB2期宫颈癌患者的复发相关。因此，本研究表明，宫颈深部间质浸润的存在可被视为决定是否应对IB2期宫颈癌患者应用辅助治疗的关键参数。
