Treatment strategy for locally advanced squamous cell cervical cancer with clinically positive pelvic lymph nodes metastasis

Takashi Shibutani, Shoji Nagao, Kazuhiro Suzuki, Kasumi Yamamoto, Tomoatsu Jimi, Hiroko Yano, Miho Kitai, Takaya Shiozaki, Satoshi Yamaguchi

Research output: Contribution to journalArticlepeer-review

Abstract

Aim: To determine the optimal treatment for locally advanced squamous cell cervical cancer with clinical positive pelvic lymph nodes metastasis (cN1). Methods: We enrolled patients with squamous cell cervical cancer with 2008 FIGO stages IB, IIA, or IIB diagnosed with cN1, who were treated at Hyogo Cancer Center between April 2010 and December 2016. Patients with para-aortic lymph nodes metastasis were excluded. Results: Of the 69 eligible patients, 24 underwent concurrent chemoradiotherapy (CCRT), 11 underwent radical hysterectomy with pelvic lymphadenectomy (RH) with or without adjuvant RT, and 34 underwent neoadjuvant chemotherapy (NAC) followed by RH as initial treatment. The regimens of NAC included dose-dense TC (paclitaxel 80 mg/m2, days 1, 8, 15; and carboplatin at an area under the curve = 6 on day 1, every 3 weeks) and dose-dense TP (paclitaxel 80 mg/m2 on days 1, 8, 15; and cisplatin 75 mg/m2 on day 1, every 3 weeks). The median observation period was 57 (12–107) months. The 5-year disease-free survival rates of the CCRT, RH, and NAC groups were 78.7%, 63.6%, and 88.2%, respectively (p = 0.14). The 5-year overall survival rates of the CCRT, RH, and NAC groups were 78.6%, 70.1%, and 94.1%, respectively (p = 0.11). Conclusions: We recommend avoiding RH as primary treatment for cN1 with locally advanced squamous cell cervical cancer. Although CCRT should be considered for cN1, further studies are required to determine if NAC followed by RH will serve as an effective option.

Original languageEnglish
Pages (from-to)2442-2448
Number of pages7
JournalJournal of Obstetrics and Gynaecology Research
Volume47
Issue number7
DOIs
Publication statusPublished - Jul 2021
Externally publishedYes

Keywords

  • cervical cancer
  • concurrent chemoradiotherapy
  • lymph nodes
  • metastasis
  • neoadjuvant chemotherapy

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

Fingerprint

Dive into the research topics of 'Treatment strategy for locally advanced squamous cell cervical cancer with clinically positive pelvic lymph nodes metastasis'. Together they form a unique fingerprint.

Cite this