Long-term outcomes of postoperative taxane/platinum chemotherapy for early stage cervical cancer: a retrospective study

Int J Clin Oncol. 2018 Aug;23(4):715-725. doi: 10.1007/s10147-018-1249-8. Epub 2018 Feb 14.

Abstract

Background: Taxane/platinum (TP)-based combination chemotherapy is standard for the treatment of metastatic or recurrent cervical cancer. The aim of this study was to investigate the efficacy of postoperative TP therapy in early stage cervical cancer.

Methods: A retrospective review of patients with FIGO IB-IIB stage cervical cancer who were treated with radical hysterectomy and displayed surgical-pathological risk factors was performed. 122 patients were identified between 2003 and 2012. Survival was analyzed by Kaplan-Meier method and compared by the log-rank test. The Cox proportional hazards model was used to investigate predictors of survival.

Results: The median follow-up period was 82.4 months. The postoperative adjuvant therapy was TP in 82 (67.2%) patients, other chemotherapies in 10 (8.2%), radiotherapy (RT) in 25 (20.5%), and no further therapy (NFT) in 5 (4.1%). Survival was analyzed using 4 subgroups according to the postoperative adjuvant therapy. The estimated 5-year overall survival was 95.1% in the TP group, 90.0% in the other chemotherapy group, 78.9% in the RT group, and 100% in the NFT group. No significant difference of survival was observed in the subgroups. However, when analyzing only patients who displayed high-risk factors, non-TP adjuvant therapy (including RT and other chemotherapies) was independently associated with shorter survival on multivariate analysis. In the TP group, multivariate analysis revealed that a positive surgical margin was a significant predictor of shorter survival.

Conclusions: Postoperative TP is effective in patients with surgically treated early stage cervical cancer. In these populations, a positive surgical margin could be associated with poor prognosis.

Keywords: Adjuvant therapy; Cervical cancer; Radical hysterectomy; Recurrence; Survival; Taxane/platinum.

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Bridged-Ring Compounds / administration & dosage
  • Carcinoma, Squamous Cell / drug therapy
  • Carcinoma, Squamous Cell / pathology*
  • Carcinoma, Squamous Cell / surgery
  • Combined Modality Therapy
  • Female
  • Humans
  • Hysterectomy
  • Lymphatic Metastasis
  • Middle Aged
  • Neoplasm Invasiveness
  • Neoplasm Recurrence, Local / drug therapy
  • Neoplasm Recurrence, Local / pathology*
  • Neoplasm Recurrence, Local / surgery
  • Platinum / administration & dosage
  • Postoperative Care
  • Prognosis
  • Retrospective Studies
  • Survival Rate
  • Taxoids / administration & dosage
  • Uterine Cervical Neoplasms / drug therapy
  • Uterine Cervical Neoplasms / pathology*
  • Uterine Cervical Neoplasms / surgery
  • Young Adult

Substances

  • Bridged-Ring Compounds
  • Taxoids
  • taxane
  • Platinum