The Efficacy of Radical Hysterectomy plus Tailored Adjuvant Therapy in non-Bulky Node-positive Early Cervical Cancer = The Efficacy of Radical Hysterectomy plus Tailored Adjuvant Therapy in non-Bulky Node-positive Early Cervical Cancer

다국어 초록 (Multilingual Abstract)

Objective: The controversy between the proponents of radical pelvic surgery and those of radiotherapy for primary treatment in early cervical cancer still exists for a long time. The aim of this study is to demonstrate the efficacy of radical hysterectomy as primary treatment in non-bulky node-positive early cervical patients.
Methods: Patients that were diagnosed with cervical cancer and received RH at Asan Medical Center between January 2013 and December 2015 were identified from an electronic database at our center, and their medical records were reviewed retrospectively. The eligibility criteria for patients inclusion in this study were as follows: previously untreated; pathologically diagnosed cervical cancer; an age of 20-80 years at the time of surgery; laparoscopic or open radical hysterectomy with pelvic and/or para-aortic lymphadenectomy; clinical tumor or MIR tumor size under 4cm and lymph node positive in imaging study. Patients whose cell type was small cell carcinoma or neuroendocrine carcinoma, who underwent neoadjuvant chemotherapy, or who had other coexisting malignancies were excluded.
Results: Of the 53 patients, 6 patients (11.3%) were recurred, and 4 patients were died among the recurred patients. 15 patients (28.3%) were not received any adjuvant therapy after radical hysterectomy. 2years overall survival was 93%, and 3years overall survival was 90% in non-bulky lymphadenopathy cervical cancer patients. 2years recurrence-free survival rate was 86%. 15 patients (28.3%) were not received any adjuvant therapy after radical hysterectomy.
Conclusion: In non-bulky lymphadenopathy cervical patients who received radical hysterectomy as primary treatment, it presented good overall survival and recurrence-free survival rates. It was single-arm study. The necessity of multicenter prospective randomized controlled comparative study between radical pelvic surgery and radiotherapy as primary treatment in high risk early cervical cancer was highly required.