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Open Access Research article

Radical hysterectomy with adjuvant radiotherapy versus radical radiotherapy for FIGO stage IIB cervical cancer

Yanlan Chai1, Tao Wang1, Juan Wang1, Yunyi Yang1, Ying Gao1, Jiyong Gao2, Shangfeng Gao2, Yueling Wang2, Xi Zhou13 and Zi Liu1*

Author Affiliations

1 The Department of Radiotherapy Oncology of the 1st Affiliated Hospital, Xi’an Jiao Tong University, Xi’an 710061, China

2 The Department of Gynecology of the 1st Affiliated Hospital, Xi’an Jiao Tong University, Xi’an 710061, China

3 Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei 442000, China

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BMC Cancer 2014, 14:63  doi:10.1186/1471-2407-14-63

Published: 4 February 2014

Abstract

Background

The goal of this study was to compare treatment outcomes for Federation of Gynecology and Obstetrics (FIGO) stage IIB cervical carcinoma patients receiving radical surgery followed by adjuvant postoperative radiotherapy versus radical radiotherapy.

Methods

Medical records of FIGO stage IIB cervical cancer patients treated between July 2008 and December 2011 were retrospectively reviewed. A total of 148 patients underwent radical hysterectomy with pelvic lymph node dissection followed by adjuvant radiotherapy (surgery-based group). These patients were compared with 290 patients that received radical radiotherapy alone (RT-based group). Recurrence rates, progression-free survival (PFS), overall survival (OS), local control rates, and treatment-related complications were compared for these two groups.

Results

Similar rates of recurrence (16.89% vs. 12.41%, p = 0.200), PFS (log-rank, p = 0.211), OS (log-rank, p = 0.347), and local control rates (log-rank, p = 0.668) were observed for the surgery-based group and the RT-based group, respectively. Moreover, the incidence of acute grade 3–4 gastrointestinal reactions and late grade 3–4 lower limb lymphedema were significantly higher for the surgery-based group versus the RT-based group. Cox multivariate analyses found no significant difference in survival outcome between the two groups, and tumor diameter and histopathology were identified as significant prognostic factors for OS.

Conclusions

Radical radiotherapy was associated with fewer treatment-related complications and achieved comparable survival outcomes for patients with FIGO stage IIB cervical cancer compared to radical hysterectomy followed by postoperative radiotherapy.

Keywords:
Cervical carcinoma; Stage IIB; Surgery; Radiotherapy; Adverse effects