Treatment Results of Adjuvant Chemotherapy after Radical Hysterectomy for Intermediate-Risk Stage IB-IIB Cervical Cancer

Objective: The objective is to evaluate the effectiveness of chemotherapy as postoperative adjuvant therapy for stage IB-IIB cervical cancer with intermediate-risk factors. Methods: We retrospectively reviewed the medical records of 119 cervical cancer patients with intermediate-risk factors treated with radical hysterectomy and pelvic lymphadenectomy from December 1997 to September 2010. The intermediate-risk factors included bulky tumor (≥4 cm), lymphovascular space invasion, and deep stromal invasion. Sixteen patients did not receive adjuvant therapy (observation group);73 were treated with chemotherapy (CT group);30 were treated with adjuvant radiation therapy (RT group). The significance of the clinical parameters, 3- and 5-year overall survival (OS) rates of each group, was analyzed. Results: The 3- and 5-year OS rates between the observation group and adjuvant therapy group (CT plus RT groups) were not statistically different (3-year OS: 100% and 94.4%, respectively;5-year OS: 100% and 92.3%, respectively;p > 0.05). The 3- and 5-year OS rates between the CT group and RT group were also not statistically different (3-year OS: 93.6% and 96.4%, respectively;5-year OS: 80.7% and 96.4%, respectively;p < 0.05). Univariate and multivariate analysis of survival indicated that different adjuvant therapies were not independent prognostic indicators for IB-IIB cervical cancer patients with intermediate-risk factors. Conclusions: CT may have equivalent therapeutic effect as RT for stage IB-IIB cervical cancer patients with intermediate-risk factors after radical surgery, and prospective randomized trial is needed to study the effect of CT in these patients.

Comparison of two methods for evaluating lower urinary tract symptoms in cervical cancer patients following radical hysterectomy

Objective:To compare the degree of agreement and consistency of urodynamic studies(UDS)with low urinary tract symptoms(LUTS)questionnaires for evaluating LUTS in cervical cancer patients following radical hysterectomy(RH)and pelvic lymphadenectomy.Methods:From January 2012 to March 2015,204 cervical cancer patients who underwent RH in 13 hospitals were evaluated using the Incontinence Questionnaire-Female Lower Urinary Tract Symptoms(ICIQ-FLUTS)and the Overactive Bladder Symptom Score(OABSS).Urodynamic tests were also performed on these patients during the same period.Results:Study participants’age ranged from 23 to 75 years,with a mean(standard deviation)of 48.0±9.3 years.Using questionnaires,the prevalence of patients with LUTS symptoms,including storage symptoms,voiding symptoms,stress urinary incontinence(SUI)and overactive bladder(OAB)was 86.3%,77.0%,62.7%,52.9%and 14.7%,respectively.For UDS,the corresponding prevalence was 89.7%,70.1%,66.7%,46.6%and 13.2%,respectively.The diagnostic concordance of questionnaires and UDS for storage symptoms,voiding symptoms,SUI and OAB was 79.9%,66.7%,66.7%,57.4%and 79.9%,respectively.For voiding symptoms,the correlation coefficient was 0.272,which was higher than that of storage symptoms,SUI and OAB.