Can we perform adjuvant chemotherapy alone in stage IB/IIA cervical cancer meeting Sedlis criteria?

Abstract Background: The aim of this study was to evaluate the effectiveness of chemotherapy alone as postsurgical adjuvant therapy on survival of patients in stage IB/IIA cervical squamous cell carcinoma meeting Sedlis criteria. Methods: We retrospectively reviewed the records of 127 patients satisfying Sedlis criteria after radical surgery for stage IB/IIA cervical cancer from January 2009 to December 2013. Of these, 65 patients received radiotherapy (RT)/chemoradiotherapy (CRT), 62 patients received chemotherapy (CT) alone. Both the treatment modalities were compared on 5-year overall survival (OS), disease-specific survival (DSS), recurrence rates and side effects. Results: Median follow-up time for surviving patients was 75 months. The 5-year OS was similar in both the groups with 85.5% in the CT and 87.7% in the RT/CRT group, respectively, (p=0.727). Likewise, there was no significant difference in 5-year DSS between the two arms (CT: 87.1% vs. RT/CRT: 90.8%; P=0.548). Rate and the pattern of recurrence were not different between the groups. Acute toxicity was more frequent in the CT group, but was statistically insignificant (P>0.05). The incidences of urinary disturbance (P=0.003) and lymphedema (P=0.041) were fewer in the CT group. Conclusions: Adjuvant CT alone for early-stage cervical cancer patients who meet the Sedlis criteria might be a good alternative to RT/CRT.