Experience in stage IB2 cervical cancer and review of treatment

The aim of the study is to evaluate and compare the efficacy of neoadjuvant chemotherapy (NACT), radical hysterectomy (RH) and radiotherapy (RT) in the treatment of stage IB2 cervical cancer.

Medical records of 86 patients with stage IB2 cervical cancer between 1993 and 2006 were evaluated. Patients who underwent type III RH ± bilateral salphingo-oophorectomy and para-aortic and pelvic lymphadenectomy constituted the RH group (n=18). Patients who received radiotherapy constituted the RT group (n=20). Patients who underwent any of the combination chemotherapies (cisplatin/5-fluorouracyl, cisplatin/UFT® or paclitaxel/carboplatin) followed by RH or RT constituted the NACT group (n=36).

Seventy-four patients were included in the study. The median follow-up was 48.5 months and the mean tumor size was 51.4mm. The groups were similar in terms of follow-up duration and tumor size. However, the mean age of the patients was higher in the RT group and nonsquamous type cervical cancer was more frequent in the RH group. Disease free survival (DFS) and overall survival (OS) were 75.7%. DFS rate was 65% in the RT group, 77.8% in the RH group and 80.6% in the NACT group. OS rates were 65%, 77.8% and 83.3% respectively. The groups were similar in terms of DFS and OS rates.

In our study, none of the treatment modalities were shown to be superior in terms of efficacy. There is need for additional prospective studies comparing multimodal treatment regimens in stage IB2 cervical cancer.