Concurrent chemotherapy and radiotherapy in invasive cervical cancer patients with high risk factors

Radical surgery is the first choice for the treatment of early cervical cancer. Patients need radiotherapy and chemotherapy according to the risk factors.concurrent chemoradiotherapy with cisplatin is recommended according to NCCN recommended guidelines for the treatment of cervical cancer, with any post-operative high risk factors (lymph node metastasis, positive vaginal margin, and para-uterine infiltration). for cervical cancer patients without high risk factors but with moderate risk factors that meet Sedlis criteria, it is recommended to supplement post-operative pelvic external irradiation ± with concurrent chemotherapy with cisplatin.However, these adjuvant treatments can cause radioactive cystitis and proctitis, even vesicovaginal fistula, rectovaginal fistula, long or irreversible adverse reactions, affecting ovarian function in young patients who retain the ovary, which can lead to a decline in the quality of life of patients. These problems make it a hot topic whether chemotherapy can be used in postoperative adjuvant therapy of cervical cancer patients. This article reviews the research progress of adjuvant therapy for early cervical cancer.

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Perineural Invasion Should Be Regarded as an Intermediate-Risk Factor for Recurrence in Surgically Treated Cervical Cancer: A Propensity Score Matching Study

Disease Markers ◽

10.1155/2021/1375123 ◽

2021 ◽

Vol 2021 ◽

pp. 1-8

Author(s):

Ting Wan ◽

Hua Tu ◽

Lili Liu ◽

He Huang ◽

Yanling Feng ◽

...

Keyword(s):

Risk Factors ◽

Cervical Cancer ◽

Overall Survival ◽

Risk Factor ◽

High Risk ◽

Propensity Score ◽

Cancer Patients ◽

Perineural Invasion ◽

Intermediate Risk ◽

High Risk Factors

Background. Perineural invasion (PNI) is considered as a poor prognostic factor in cervical cancer, but there has been no postoperative adjuvant therapy for it, because whether it belongs to high- or intermediate-risk factors has not been determined, this study intends to provide evidences to solve this problem. Methods. We conducted a retrospective analysis of cervical cancer patients who underwent radical surgery and be reported PNI from January 2012 to June 2017 at the Sun Yat-sen University Cancer Center. After 1 : 1 propensity score matching (PSM), a group of patients without PNI was matched according to the clinical pathological features. Postoperative pathological parameters and prognosis were evaluated between the PNI and the matched groups. Results. 1836 patients were screened, of which 162 (8.8%) diagnosed as stages IB1 to IIB reported PNI. Comparing to the matched group, more PNI (+) patients had deep outer cervix stromal invasion, cervical tunica adventitia invasion, positive lymph nodes, and positive margins. Among patients without high-risk factors, PNI (+) patients had worse 3-year overall survival (90.8% vs. 98.1%, P = 0.02 ), PNI (+) patients with single intermediate-risk factor and PNI (-) patients who meet with SEDLIS criteria had similar progress free survival ( P = 0.63 ) and overall survival ( P = 0.63 ), even similar survival curves. Conclusion. PNI is related to a worse overall survival among cervical cancer patients without high-risk factors and play the role as an intermediate-risk factor.

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