Management of Stage IIB Cervical Cancer: an Overview of the Current Evidence

Curr Oncol Rep. 2020 Feb 12;22(3):28. doi: 10.1007/s11912-020-0888-x.

Abstract

Purpose of review: To review and discuss the present evidence of surgery- and radiation-based treatment strategies for stage IIB cervical cancer.

Recent findings: Recently, two randomized controlled trials compared the efficacy of neoadjuvant chemotherapy followed by radical hysterectomy (NACT + RH) with that of concurrent chemoradiotherapy (CCRT) for stage IB3-IIB cervical cancer. When these studies were combined (N = 1259), NACT + RH was associated with a shorter disease-free survival [hazard ratio (HR) 1.36, 95% confidence interval (CI) 1.13-1.64], but with a similar overall survival (HR 1.11, 95% CI 0.90-1.36) when compared with the findings for CCRT. Stage-specific analysis for stage IIB cervical cancer demonstrated that disease-free survival was significantly worse with NACT + RH than with CCRT (HR 1.90, 95% CI 1.25-2.89); however, no significant difference was observed for stage IB3-IIA cervical cancer. Based on the results of recent level I evidence, the standard treatment for stage IIB cervical cancer remains CCRT.

Keywords: Cervical cancer; Concurrent chemoradiotherapy; Neoadjuvant chemotherapy; Radical hysterectomy; Stage II; Survival.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Adenocarcinoma / pathology
  • Adenocarcinoma / therapy*
  • Antineoplastic Agents / therapeutic use
  • Carcinoma, Adenosquamous / pathology
  • Carcinoma, Adenosquamous / therapy
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / therapy
  • Chemoradiotherapy*
  • Combined Modality Therapy
  • Female
  • Humans
  • Hysterectomy* / methods
  • Neoadjuvant Therapy*
  • Neoplasm Staging
  • Practice Guidelines as Topic
  • Prognosis
  • Randomized Controlled Trials as Topic
  • Uterine Cervical Neoplasms / pathology
  • Uterine Cervical Neoplasms / therapy*

Substances

  • Antineoplastic Agents