Non-squamous histology but not adjuvant therapy affects survival in stage IB-IIA cervical cancer patients with intermediate risk following radical hysterectomy

Objective: Radiotherapy is usually recommended following radical hysterectomy (RH) in early-stage cervical cancer with intermediate risk. However, adjuvant radiotherapy only decreases recurrence but not overall survival. This study aimed to compare different adjuvant modalities's efficacy and to identify prognostic factors among these patients. Methods: A single-center retrospective study was conducted between 2001 and 2015 on FIGO stage IB-IIA cervical cancer patients with intermediate risk following RH. 97 patients were enrolled for analysis. The patients underwent either RH and chemotherapy (n = 24), RH and radiotherapy (n = 21), or RH and close surveillance (n = 52). Prognostic factors that affected disease-free survival (DFS) and overall survival (OS), were compared by Kaplan-Meier analysis. Cox regression was used for univariate and multivariate analyses. Results: The median follow-up period was 117.7 months. There was no statistical difference between 5-year DFS and OS among patients receiving different adjuvant treatments, but patients with non-squamous histology had a lower 5-year DFS (p = 0.014). Multivariate analysis demonstrated no factors but only non-squamous histology significantly predicted DFS (HR = 3.565, 95% CI 1.334-9.531). Conclusions: Non-squamous histology, but not different adjuvant treatment, affects DFS in patients with stage IB-IIA cervical cancer with intermediate pathological risk following RH.