Ning Li, Binbin Tu, Rong Zhang, Xiaoguang Li, Bin Li, Shaokang Ma,  Lingying Wu

Department of Gynecology, Cancer Hospital Chinese Academy of MedicalSciences, Beijing.

Objective：Bulkylocal tumor (≥100px) is a poor prognostic factor for early stage cervical cancerpatients. Most of the locally advanced cervical cancer patients needpostoperative radiotherapy. However, some tumors shrink obviously afterneo-adjuvant treatment. Thus, whether this subgroup of the patients’ needspostoperative therapy remains unclear. The aim of our study is to evaluate therole of postoperative adjuvant treatment in stage IB2/IIA2 cervical cancerpatients without pathological risk factors afterneo-adjuvant treatment followedby radical surgery. Method：Themedical records of the patients referred to Cancer Hospital, Chinese Academy ofMedical Sciences between Jan 1^st, 2000 and Dec 31^st, 2010with stage IB2/IIA2 cervical cancer who underwent neo-adjuvant chemotherapy ±brachytherapy followed by radical surgery were reviewed. Among these patients, onehundred and three patients who had no risk factor according to pathologicalfindings after surgery were retrospectively analyzed. Result：Medianage at diagnosis was 42 years old. Histological type of 95.1% (98/103) patientswas squamous cell carcinoma, and 4.9% was adenocarcinoma or adenosquamouscarcinoma. 84.5% (87/103) patients were of stage IB2. Seventeen patientsreceived postoperative external pelvic radiotherapy (RT). Fifteen patientsreceived postoperative chemotherapy (CT) for 2-4 cycles, and the remaining 71cases received no postoperative treatment (OB). The median duration offollow-up was 54 (45-82) months. Seven patients had recurrence (2 in RT; 2 inCT; 3 in OB). The overall 5-year recurrence rate (RR) was 6.8%. Five-year RR ofeach group OB, RT and CT were 4.2%, 11.8% and 13.3%, respectively (P=0.351).The overall 2-year and 5-year OS were 98.0% and 96.8%, respectively. Five-yearOS of each group were 98.5% (OB), 86.5% (RT) and 85.7% (CT), respectively (P=0.109).Conclusion：StageIB2/IIA2 cervical cancer patients without pathological risk factors after neo-adjuvant therapy followed by radical surgery had a relatively good prognosis. Thissubgroup of cervical cancer patients might get little benefit frompostoperative adjuvant therapy.

Key Words：cervicalcancer  locally advanced stage  risk factor