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Abstract
To compare the oncologic outcomes between chemoradiotherapy (CRT) and radical hysterectomy followed by tailored adjuvant therapy in patients with early cervical cancer presenting with pelvic lymph node metastasis. We retrospectively analyzed the medical records of women with early cervical cancer presenting with positive pelvic nodes identified on pretreatment imaging assessment. Propensity score matching was employed to control for the heterogeneity between two groups according to confounding factors. Overall survival, disease-free survival, and pattern of failure were compared between the two groups. A total of 262 patients were identified; among them, 67 received definitive CRT (group A), and 195 received hysterectomy (group B). Adjuvant therapy was administered to 88.7% of group B. There were no significant differences between group A and group B regarding the 5-year overall survival rates (89.2% vs. 89.0%) as well as disease-free survival rates (80.6% vs. 82.7%), and patterns of failure. Distant metastasis was the major failure pattern identified in both groups. In multivariate analysis, non-squamous histology was significantly associated with poorer overall survival. As there are no significant differences in 5-year OS, DFS, and patterns of failure, definitive CRT could avoid the combined modality therapy without compromising oncologic outcomes.

Affiliations

Jongmoo Park  1 , Yeon-Joo Kim  2 , Mi-Kyung Song  3 , Joo-Hyun Nam  4 , Sang-Yoon Park  5 , Young-Seok Kim  6 , Joo-Young Kim  2
1 Department of Radiation Oncology, Kyungpook National University Chilgok Hospital, Daegu 41404, Korea.
2 Department of Radiation Oncology, Proton Therapy Center, National Cancer Center, Goyang-si 10408, Gyeonggi-do, Korea.
3 Biometrics Research Branch and Biostatistics Collaboration Unit, National Cancer Center, Goyang-si 10408, Gyeonggi-do, Korea.
4 Department of Obstetrics and Gynecology, Asan Medical Center, University of Ulsan, College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea.
5 Center for Uterine Cancer, National Cancer Center, Goyang-si 10408, Gyeonggi-do, Korea.
6 Department of Radiation Oncology, Asan Medical Center, University of Ulsan, College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea.