Comparison of surgical and radio-chemotherapy oncology outcomes for cervical adenocarcinoma FIGO2018 stage Ⅱ B

Abstract Objective This study aimed to explore the optimal treatment strategy for International Federation of Gynecology and Obstetrics 2018 stage ⅡB cervical adenocarcinoma patients. Methods cervical adenocarcinoma patients who underwent radical hysterectomy and radical radio-chemotherapy were screened from the clinical diagnosis and treatment for cervical cancer in China database. The 5-year overall survival (OS) and disease-free survival (DFS) were compared using the overall population study and propensity score matching. Results 68 FIGO2018 stage Ⅱ B cervical adenocarcinoma patients were eligible for inclusion. In the overall population study, there was no statistical difference in 5-year OS between the surgery group (n = 41) and the radical radio-chemotherapy group (n = 27), but their DFS was better than that of the radical radio-chemotherapy group (OS: 85.7%vs.62.8%, P = 0.058; DFS: 83.7%vs.59.2%, P = 0.035), the difference was statistically significant. Cox multivariate analysis showed that patients with FIGO2018 stage Ⅱ B cervical adenocarcinoma had worse 5-year OS (HR = 2.036, 95%CI: 0.451–9.21, P = 0.355) and DFS (HR = 1.296, 95%CI: 0.344–5.030, P = 0.708). After 1:1PSM, there were no significant differences in OS and DFS between the surgery group (n = 16) and the radical radio-chemotherapy group (n = 16)(OS: 79.8%vs.92.3%, P = 0.292; DFS: 85.6%vs.68.8%, P = 0.228). Cox multivariate analysis showed that treatment was not an independent risk factor for worse 5-year OS (HR = 0.346, 95%CI: 0.035–3.441, P = 0.365) or DFS (HR = 0.399, 95%CI: 0.075–2.216, P = 0.282). In terms of recurrence after treatment in patients with FIGO2018 stage Ⅱ B cervical adenocarcinoma, the results were consistent before and after matching, and there was no statistical difference between the two groups in terms of recurrence, recurrence time, recurrence site after recurrence. Conclusion For patients with FIGO 2018 stage Ⅱ B cervical adenocarcinoma, radical chemoradiotherapy did not result in better oncology outcome.