Postoperative adjuvant therapy for stage IA-IIA cervical adenocarcinoma (FIGO 2018) with one intermediate-risk factor: a multicentre retrospective cohort study of 63,926 cases.

Objective: To compare the 5-year oncological outcomes of different adjuvant treatment modalities in patients with FIGO 2018 stage IA-IIA cervical adenocarcinoma who underwent open radical hysterectomy and one intermediate-risk pathological factor.

Methods: Based on the Four C database (between 2004 and 2018,n=63,926), patients with FIGO 2018 stage IA-IIA cervical adenocarcinoma and only one intermediate-risk pathological factor underwent open extensive hysterectomy. All patients were divided into three groups, namely, the simple surgery group (radical hysterectomy, RH), postoperative adjuvant chemotherapy group (radical hysterectomy and chemotherapy, RH + CT), and postoperative adjuvant chemoradiotherapy group (radical hysterectomy and radiotherapy/concurrent chemoradiotherapy, RH + RT/CCRT). The 5-year OS and DFS rates were compared among the three groups.

Results: Of the 219 cervical adenocarcinoma patients with only one intermediate-risk pathological factor, 50 patients had RH; 54 patients had RH + CT; and 115 patients had RH + RT/CCRT. There were no significant differences in 5-year OS and 5-year DFS rates among the three groups (RH vs. RH + CT: 92.7% vs. 90.3%, P = 0.749; 88.5% vs. 85.1%, P = 0.680, RH vs. RH + RT/CCRT: 90.7% vs. 82.3%, P = 0.484; 84.4% vs. 90.1%, P = 0.494, RH + CT vs. RH + RT/CCRT: 89.9% vs. 90.6%, P = 0.815; 90.5% vs. 90.8%, P = 0.905).

Conclusion: Postoperative adjuvant chemotherapy or chemoradiotherapy did not significantly improve the outcomes of FIGO 2018 IA-IIA cervical adenocarcinoma patients with only one intermediate risk factor.