Adjuvant chemotherapy and radiation in patients with poor prognostic stage Ib/IIa cervical cancer

After radical hysterectomy and pelvic lymphadenectomy, 35 women with multiple negative prognostic factors (nodal metastases, stromal invasion > 65%, parametrial extension, positive surgical margins, lymphovascular involvement, lesion size > 4 cm, and adenosquamous or poorly differentiated cancers) were offered adjuvant therapy. Thirteen patients (37.1%) received radiation alone and 22 (62.9%) were treated with a platinum-based regimen of chemotherapy and radiotherapy. In the group receiving radiation, 2 (14.3%) had recurrences. In the 22 women treated with both modalities, there have been no recurrences with a mean follow-up time of 37.1 months. The results in the combined modality group were encouraging given the fact that these women had on average 3.5 poor prognostic features compared to the radiotherapy group where there was an average of 2.2 high-risk factors.