Full-Thickness Stromal Invasion in Cervical Cancer Patients Treated with Postradiotherapy

OBJECTIVE: To explore the value of adjuvant radiation therapy for cervical cancer patients who have undergone standard abdominal radical hysterectomy and pelvic lymph node dissection for frill-thickness stromal invasion (FTSI). STUDY DESIGN: A retrospective review was performed using the records of 1,125 patients with FIGO stage IB to IIA cervical cancer who had undergone a radical hysterectomy from January 2006 to December 2016. According to the inclusion criteria, 193 suitable patients were selected and divided into 2 groups: conventional dose RT group (CDRT) and high-dose RT group (HDRT). The Kaplan-Meier method was used to determine the hazard ratios of overall survival (OS), progression-free survival (PFS), and pelvic failure-free survival (PFFS). The log-rank method was used to assess the differences between groups. RESULTS: Univariate and Cox multivariate analysis showed that the values of 5-year OS, PFS, and PFFS were 85.78%, 81.07%, and 87.28% in the CDRT group and 81.47%, 79.28%, and 88.09% in the HDRT group, respectively. The 5-year OS and PFS values were independently associated with FTSI. Higher postoperative radiotherapy dose had no significant effect on OS, PFS, and PFFS at 5 and 10 years (p>0.05). CONCLUSION: FTSI is a poor prognostic variable for early cervical cancer. The enhancement of external beam therapy or brachytherapy after conventional radiotherapy had no significant correlation with OS, PFS, and PFFS.