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. 2008 Nov;111(2):265-70.
doi: 10.1016/j.ygyno.2008.07.050. Epub 2008 Sep 6.

Treatment patterns of FIGO Stage IB2 cervical cancer: a single-institution experience of radical hysterectomy with individualized postoperative therapy and definitive radiation therapy

Oliver Zivanovic  1 , Kaled M Alektiar, Yukio Sonoda, Qin Zhou, Alexia Iasonos, William P Tew, John P Diaz, Dennis S Chi, Richard R Barakat, Nadeem R Abu-Rustum
Affiliations

Treatment patterns of FIGO Stage IB2 cervical cancer: a single-institution experience of radical hysterectomy with individualized postoperative therapy and definitive radiation therapy

Oliver Zivanovic et al. Gynecol Oncol. 2008 Nov.

Abstract

Objective: The treatment of FIGO stage IB2 cervical cancer is controversial. Our aim was to assess treatment patterns, outcomes, and complications in patients with stage IB2 cervical cancer.

Methods: A retrospective study of patients with stage IB2 cervical carcinoma at a single institution between January 1982 and September 2006 was performed. To adequately control treatment variables, we only included patients who underwent their entire treatment at our institution. Toxicity was assessed using NCI Common Toxicity Criteria (CTC).

Results: We identified 82 patients, of whom 47 met the strict inclusion criteria. Of these, 27 patients (57%) underwent primary radical hysterectomy (RH) and 20 (43%) were treated with definitive radiation/chemoradiation therapy (RT/CRT). Patients selected for RT/CRT had a higher American Society of Anesthesiologist (ASA) score than those selected for surgery (P=0.037). The 3-year progression free survival rate was 52% for the RH group and 55% for the RT/CRT group (P=0.977). The 3-year overall survival rates were 72% and 55%, respectively (P=0.161). Overall, 52% of patients in the RH group received postoperative radiation therapy as part of their adjuvant treatment. CTC grade 3, 4, and 5 complications affected 5 patients (19%) in the RH group and 3 (15%) in the RT/CRT group.

Conclusion: Both RH and definitive RT/CRT are adequate management strategies for patients with FIGO stage IB2 cervical cancer. However, there was a subset of patients in whom RH as monotherapy was appropriate. Further studies are needed to evaluate the role of new preoperative models that will accurately identify these patients.

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Conflict of interest statement

CONFLICT OF INTEREST STATEMENT

  1. Oliver Zivanovic, MD: no conflicts of interest to declare

  2. Kaled Alektiar, MD: no conflicts of interest to declare

  3. Yukio Sonoda, MD: Plasma Surgical – research support; Covidien – Consultant; Genzyme – Speaker

  4. Qin Zhou, PhD: no conflicts of interest to declare

  5. Alexia Iasonos, PhD: no conflicts of interest to declare

  6. William P. Tew, MD: no conflicts of interest to declare

  7. John P. Diaz, MD: no conflicts of interest to declare

  8. Dennis S. Chi, MD: no conflicts of interest to declare

  9. Richard R. Barakat, MD: no conflicts of interest to declare

  10. Nadeem R. Abu-Rustum, MD: no conflicts of interest to declare

Figures

Figure 1
Figure 1
A cervical lesion classified as FIGO Stage IB2 cervical cancer
See this image and copyright information in PMC

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