Risk strata-based therapy and outcome in stage Ib–IIa carcinoma cervix: single-centre ten-year experience

20 Aug 2013
RS Kundargi, B Guruprasad, PS Rathod, PN Shakuntala, K Shobha, VR Pallavi, K Umadevi, UD Bafna

Aim: To review the outcome of stage (Ib, IIa), cervical cancer patients were primarily treated with radical hysterectomy and risk-based postoperative therapy.

Material and methods: Between January 2001 and December 2011, 601 cases underwent surgery followed by tailored therapy. Patients were classified into low risk (pelvic lymph node negative, tumour less than 4 cm, no evidence of lympho-vascular invasion, less than one-third of thickness of surgical stoma involved), intermediate risk (positive lympho-vascular space invasion, tumour size more than 4 cm, and deep invasion of cervical stroma), and high risk (pelvic lymph node involved, positive parametrial, or vaginal margins). Postoperative adjuvant therapy in the form of radiotherapy alone to those with intermediate risk and chemo-radiotherapy to those with high risk was given to patients. The median follow-up was 60 months.

Results: The majority of patients had intermediate risk. The overall event-free survival (EFS) at five years was 74.37%, with EFS of 86.5% in those with low-risk group, 73% in those with intermediate-risk group, and 64% in the high-risk group. In conclusion, risk strata-based adjuvant postoperative therapy is able to provide a favourable outcome in patients with stage Ib–IIa cervical cancer with a nearly 11% improvement in survival compared with historical control.

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