title: Promising treatment results of adjuvant chemotherapy following radical hysterectomy for intermediate risk stage 1B cervical cancer.
abstract: OBJECTIVE
  The aim of this retrospective study is to evaluate the efficacy of adjuvant chemotherapy following radical hysterectomy for intermediate risk stage IB cervical cancer.
  
  
  METHODS
  From January 1993 to December 2007, a total of 100 patients of stage IB were enrolled in this study who had at least two of the following three intermediate risk factors (deep stromal invasion, lymphovascular space involvement, and large tumor size) after radical hysterectomy and all patients had no high risk factors and no radiotherapy. Of these patients, 22 patients had surgery only and 78 patients had cisplatin-based combination chemotherapy as adjuvant therapy postoperatively to improve survival. Kaplan-Meier survival curves and Cox's proportional-hazards regression model and log-rank test were used for survival analysis and to estimate the impact of prognostic factors on survival.
  
  
  RESULTS
  The mean age was 52 years (range, 28 to 76 years). The overall survival rate of all intermediate tumors are 92% (92/100). Surgery only group is 81.8% (18/22) and adjuvant chemotherapy group is 94.9% (74/78). Comparison of survival between two groups revealed significant statistical difference in both univariant and multivariant survival analysis (P<0.05). The main toxicities of adjuvant chemotherapy were bone marrow suppression (18%), nausea and vomiting (5.2%) and alopecia in etoposide-cisplatin chemotherapy group (100%) but most side effects of postoperative adjuvant chemotherapy were transient, reversible and within acceptable limits to all patients.
  
  
  CONCLUSIONS
  Cisplatin based combined adjuvant chemotherapy for intermediate risk tumors after radical hysterectomy is promising with significant improvement of overall survival and with acceptable toxicity profile.
authors: Department of Obstetrics and Gynecology, Kosin University College of Medicine, Busan, Korea.
authors: Tae Yeon
authors: TY
authors: Lee
authors: Yi Jo
authors: YJ
authors: Jeung
authors: Chun Jun
authors: CJ
authors: Lee
authors: Heung Yeol
authors: HY
authors: Kim
authors: Sung Han
authors: SH
authors: Kim
authors: Won Gyu
authors: WG
authors: Kim
keywords: Chemotherapy, Adjuvant; Cisplatin; Survival analysis; Uterine cervical neoplasm