Analysis Of The Efficacy And Prognostic Factors After Radical Surgery For Stage ⅠB2/ⅡA2 Cervical Cancer

Objective We aimed to evaluate the survival,complications and prognostic factors in IB2/IIA2(FIGO 2009)cervical cancer who were treated primarily with radical surgery.Methods From January 2011 to January 2018,patients with stage IB2/IIA2 cervical cancer who underwent radical surgery were enrolled and evaluated in this retrospective research.Survival was estimated using the Kaplan-Meier method with significance being calculated using the log-rank test,and multivariate regression analyses were performed to determine prognostic factors.Results(1)The median age of 975 patients with cervical cancer was 50 years old(45-58 years old);clinical stage:422 cases(43.3%)of stage IB2 and 553 cases(56.7%)of stage ⅡA2.(2)Among 975 cases of cervical cancer patients who underwent Q-M classification C2 surgery,877 cases(89.9%)were given adjuvant therapy due to the existence of postoperative intermediate and high risk factors.Among the 975 patients,198 patients(20.3%)had grade 3-4 complications,including 194(19.9%)short-term complications and 86(8.8%)long-term complications.The 878 patients with surgery+adjuvant therapy had grade 3 to 4 non-hematological complications were 19.5%,and 97 patients with surgery alone were 13.4%,there was no significant difference between the two(P=0.147).(3)All 975 patients with cervical cancer were followed up,and the median follow-up time was 48 months.During the follow-up period,140 cases(14.3%)had recurrence,including 55 cases(5.6%)of local recurrence,71 cases(7.3%)of distant metastasis,and 14 cases(1.4%)of local recurrence and distant metastasis.The overall recurrence rate of patients with surgery alone and patients with surgery+adjuvant therapy was similar(16.7%vs 14.1%,P=0.527),but there was a significant difference in the local recurrence rate.were 11.3%and 5.0%,respectively(P=0.01).The 5-year progression-free survival(PFS)rate and 5-year overall survival(OS)rate of patients with stage ⅠB2/ⅡA2 cervical cancer were 80.8%and 85.9%,respectively.Multivariate analysis showed that adenocarcinoma/adenosquamous carcinoma(P=0.007),pelvic lymph node metastasis(P=0.005),and para-aortic lymph node metastasis(P=0.002)were independent risk factors for recurrence;adenocarcinoma/adenosquamous carcinoma(P=0.004),pelvic lymph node metastasis(P=0.009),and para-aortic lymph node metastasis(P=0.001)were independent risk factors for survival.Conclusion Radical surgery combined with adjuvant therapy is a feasible and effective treatment for patients with stage IB2/IIA2 cervical cancer,with high 5-year survival rate and acceptable complication rate.Conclusions radical surgery followed by adjuvant therapy is a feasible and effective treatment in IB2/IIA2 cervical cancer,with a high 5-year survival rate and an acceptable incidence of complications.