Comparative Study

. 2020 Feb 12;22(3):28.

doi: 10.1007/s11912-020-0888-x.

Management of Stage IIB Cervical Cancer: an Overview of the Current Evidence

Shinya Matsuzaki¹, Maximilian Klar², Mikio Mikami³, Muneaki Shimada⁴, Brendan H Grubbs⁵, Keiichi Fujiwara⁶, Lynda D Roman^{1

7}, Koji Matsuo^{8

9}

Affiliations

¹ Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, 2020 Zonal Avenue IRD520, Los Angeles, CA, 90033, USA.
² Department of Obstetrics and Gynecology, University of Freiburg, Freiburg, Germany.
³ Department of Obstetrics and Gynecology, Tokai University School of Medicine, Isehara, Kanagawa, Japan.
⁴ Department of Obstetrics and Gynecology, Tohoku University School of Medicine, Sendai, Miyagi, Japan.
⁵ Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA.
⁶ Department of Gynecologic Oncology, Saitama Medical University International Medical Center, Saitama, Japan.
⁷ Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA.
⁸ Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, 2020 Zonal Avenue IRD520, Los Angeles, CA, 90033, USA. koji.matsuo@med.usc.edu.
⁹ Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA. koji.matsuo@med.usc.edu.

PMID: 32052204
PMCID: PMC7759090
DOI: 10.1007/s11912-020-0888-x

Comparative Study

Management of Stage IIB Cervical Cancer: an Overview of the Current Evidence

Shinya Matsuzaki et al. Curr Oncol Rep. 2020.

. 2020 Feb 12;22(3):28.

doi: 10.1007/s11912-020-0888-x.

Authors

Shinya Matsuzaki¹, Maximilian Klar², Mikio Mikami³, Muneaki Shimada⁴, Brendan H Grubbs⁵, Keiichi Fujiwara⁶, Lynda D Roman^{1

7}, Koji Matsuo^{8

9}

Affiliations

¹ Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, 2020 Zonal Avenue IRD520, Los Angeles, CA, 90033, USA.
² Department of Obstetrics and Gynecology, University of Freiburg, Freiburg, Germany.
³ Department of Obstetrics and Gynecology, Tokai University School of Medicine, Isehara, Kanagawa, Japan.
⁴ Department of Obstetrics and Gynecology, Tohoku University School of Medicine, Sendai, Miyagi, Japan.
⁵ Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA.
⁶ Department of Gynecologic Oncology, Saitama Medical University International Medical Center, Saitama, Japan.
⁷ Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA.
⁸ Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, 2020 Zonal Avenue IRD520, Los Angeles, CA, 90033, USA. koji.matsuo@med.usc.edu.
⁹ Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA. koji.matsuo@med.usc.edu.

PMID: 32052204
PMCID: PMC7759090
DOI: 10.1007/s11912-020-0888-x

Abstract

Purpose of review: To review and discuss the present evidence of surgery- and radiation-based treatment strategies for stage IIB cervical cancer.

Recent findings: Recently, two randomized controlled trials compared the efficacy of neoadjuvant chemotherapy followed by radical hysterectomy (NACT + RH) with that of concurrent chemoradiotherapy (CCRT) for stage IB3-IIB cervical cancer. When these studies were combined (N = 1259), NACT + RH was associated with a shorter disease-free survival [hazard ratio (HR) 1.36, 95% confidence interval (CI) 1.13-1.64], but with a similar overall survival (HR 1.11, 95% CI 0.90-1.36) when compared with the findings for CCRT. Stage-specific analysis for stage IIB cervical cancer demonstrated that disease-free survival was significantly worse with NACT + RH than with CCRT (HR 1.90, 95% CI 1.25-2.89); however, no significant difference was observed for stage IB3-IIA cervical cancer. Based on the results of recent level I evidence, the standard treatment for stage IIB cervical cancer remains CCRT.

Keywords: Cervical cancer; Concurrent chemoradiotherapy; Neoadjuvant chemotherapy; Radical hysterectomy; Stage II; Survival.

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Figures

**Fig. 1**
Forest plots for NACT + RH versus chemoradiotherapy. Forest plots for OS (A), for OS (SCC) (B), and for DFS (C). NACT + RH showed significantly lower DFS and non-significant lower OS compared to chemoradiotherapy alone. I² was 0% in both studies; thus, a fixed analysis was performed. Abbreviations; NACT, neoadjuvant chemotherapy, RH, radical hysterectomy; OS, overall survival; DFS, disease-free survival. Some values listed above might be slightly different from the original values because of calculating by Revman 5.3

**Fig. 2**
Subanalysis of the OS and DFS from the NACT + RH versus CCRT trials. Stage-specific subanalyses for OS (A), for DFS (B), and for OS stratified for histology (C). A significantly worse DFS was observed for stage IIB cervical cancer for the NACT + RH group (B). NACT, neoadjuvant chemotherapy; RH, radical hysterectomy; OS, overall survival; DFS, disease-free survival; SCC, squamous cell carcinoma; ADC, advanced cervical adenocarcinoma; ADS, adenosquamous carcinoma. Some values listed above might be slightly different form original values because of calculating by Revman 5.3

See this image and copyright information in PMC

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References

1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394–424. - PubMed
1. Bhatla N, Berek JS, Cuello Fredes M, Denny LA, Grenman S, Karunaratne K, et al. Revised FIGO staging for carcinoma of the cervix uteri. Int J Gynaecol Obstet. 2019;145(1):129–35. - PubMed
1. Matsuo K, Machida H, Mandelbaum RS, Konishi I, Mikami M. Validation of the 2018 FIGO cervical cancer staging system. Gynecol Oncol. 2019;152(1):87–93. - PMC - PubMed
2. This study is important as it provides information regarding the change in the cervical cancer staging system from FIGO 2014 to FIGO 2018.
1. Cervical cancer. National Comprehensive Cancer Network (US) NCCN Clinical Practice Guideline in Oncology. Version 5. 2019. <https://www.nccn.org/professionals/physician_gls/pdf/cervical.pdf> (accessed 11/25/2019).
1. Yoon A, Park JJ, Park BK, Lee YY, Paik ES, Choi CH, et al. Long-term Outcomes of MRI Stage IIB Cervical Cancer. Int J Gynecol Cancer. 2016;26(7):1252–7. - PubMed

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Management of Stage IIB Cervical Cancer: an Overview of the Current Evidence

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