Impact of various treatment modalities on the outcome of stage IB1-IIA cervical adenocarcinoma.
OBJECTIVE
To evaluate the outcomes of patients with stage IB1-IIA cervical adenocarcinoma treated by various modalities in order to formulate a better treatment strategy.


METHODS
The impact of various treatment modalities on the prognosis of 258 patients with stage IB1-IIA cervical adenocarcinoma was investigated. The therapeutic modalities included radical surgery (n=174); radical surgery followed by adjuvant radiation therapy (RT), such as RT alone or concurrent chemo-radiotherapy (CCRT) (n=46); or primary RT or CCRT (n=38).


RESULTS
As compared with patients in the surgery-only group, patients with 1 postoperative major risk who underwent surgery followed by RT or CCRT had a significantly higher likelihood of disease relapse (2.3-fold, P=0.041) and disease-related death (2.9-fold, P=0.014). The likelihood of recurrence (P=0.32) and death (P=0.58) did not differ between patients who underwent adjuvant RT or CCRT for 1 major risk factor and those who underwent primary RT or CCRT. By contrast, patients with more than 1 major risk factor had a higher likelihood of disease recurrence (2.9-fold, P=0.037) and disease-related death (3.4-fold, P=0.051) than those who underwent primary RT or CCRT.


CONCLUSIONS
Radical surgery is recommended for patients with stage IB1-IIA cervical adenocarcinomas without contraindications. Those with more than 1 postoperative pathologic risk factor had the worst prognosis despite adjuvant RT or CCRT.
Gynecologic Cancer Center, Department of Obstetrics and Gynecology, Cathay General Hospital, Taipei, Taiwan.
Yu-Li
YL
Chen
Chih-Ming
CM
Ho
Chi-An
CA
Chen
Ying-Cheng
YC
Chiang
Chia-Yen
CY
Huang
Chang-Yao
CY
Hsieh
Wen-Fang
WF
Cheng
D000230:Adenocarcinoma / Q000473:pathology / Q000628:therapy*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011379:Prognosis; D018714:Radiotherapy, Adjuvant / Q000379:methods; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000628:therapy*
D000970:Antineoplastic Agents