title: [Impact of postoperative adjuvant therapy on prognosis of low-risk cervical cancer: analysis of 208 cases].
abstract: OBJECTIVE
  To investigate the effect of adjuvant chemotherapy on the prognosis of patients with low-risk cervical cancer (without pelvic lymph node metastasis, parametrial involvement, positive surgical margin, primary tumor size > 4 cm, deep cervical stromal invasion, or lymph-vascular space invasion).
  
  
  METHODS
  The clinical data of 208 patients with low-risk cervical cancer were studied retrospectively to analyze the indications of adjuvant chemotherapy and its relationship with tumor recurrence and the patients' survival.
  
  
  RESULTS
  The median follow-up time of the cohort was 73 months. The overall tumor recurrence rate was 4.8% and the total 5-year survival rate of the patients was 96.0%. Sixty-nine of the patients received adjuvant chemotherapy (Taxol+Cisplatin) after the operation with a median of 2.5 (2-4) courses. Univariate analysis showed that the histological tumor grade was significantly associated with adjuvant chemotherapy (P<0.001). In the 114 grade III patients, 50 received adjuvant chemotherapy as compared with 19 in the 94 grade I-II patients. Among the grade III patients, no significant differences was found in the overall survival rate (97.0% vs 95.0%) or tumor recurrence rate (4.0% vs 4.7%) rate between the patients with adjuvant chemotherapy and those without. The tumor size (2 cm or less vs >2 cm) was significantly associated with tumor recurrence rate (1.1% vs 7.5%, P=0.034) and the overall 5-year survival rate (100.0% vs 93.0%, P=0.034) in the 208 patients. In the 139 patients receiving only surgical treatment, the tumor recurrence and 5-year survival rates were not significantly correlated with the histologic grade, age, FIGO staging, gross type, tumor size or histologic type.
  
  
  CONCLUSIONS
  B There has been no sufficient evidence to support the prescription of postoperative adjuvant chemotherapy for low-risk cervical cancer based on histological grading of the tumor, which may not help in reducing tumor recurrence or improving the long-term survival of the postoperative patients.
authors.affiliation: Sun Yat-sen University Cancer Center, South China State Key Laboratory of Oncology, Collaborative Innovation Center of Cancer Medicine, Department of Gynecology, Guangzhou 510000, China. E-mail: sffnyd521@163.com.
authors.forename: Fei
authors.initials: F
authors.lastname: Sun
authors.forename: Yanfang
authors.initials: Y
authors.lastname: Li
authors.forename: Jihong
authors.initials: J
authors.lastname: Liu
authors.forename: Ying
authors.initials: Y
authors.lastname: Xiong
mesh_terms: D000328:Adult; D000368:Aged; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy* / Q000401:mortality* / Q000473:pathology; D055815:Young Adult