Comparison of postoperative adjuvant platinum-based chemotherapy and no further therapy after radical surgery in intermediate-risk early-stage cervical cancer

Abstract Background An optimal treatment for intermediate-risk early-stage cervical cancer has not been reported. The aim of this study was to identify populations that require platinum-based adjuvant chemotherapy and those who require no further therapy for intermediate-risk early-stage cervical cancer. Methods Between January 2007 and December 2018, we reviewed the records of patients diagnosed with cervical cancer International Federation of Gynecology and Obstetrics stage IA2-IIA2, and who were classified as intermediate-risk group for recurrence. These patients were either treated with chemotherapy or received no further therapy after radical hysterectomy. We examined the overall survival and recurrence-free survival rates in the chemotherapy group and the group that received no further therapy. Results Of the 151 patients, 55 underwent chemotherapy and 96 received no further therapy. In the group that received no further therapy, the squamous cell carcinoma group with three risk factors and the non-squamous cell carcinoma group with two to three risk factors had significantly poorer recurrence-free-survival rates than the other groups, and chemotherapy significantly improved the recurrence-free-survival rates in this group. Recurrence-free-survival rates were not significantly different between the squamous cell carcinoma group with one to two risk factors and non-squamous cell carcinoma group with one risk factor. Conclusion CT is essential for the SCC group with three risk factors and non-SCC group with two to three risk factors. NFT was preferable for the other groups with fewer risk factors.