Comparison between conventional surgery and radiotherapy for FIGO stage I-II cervical carcinoma: A retrospective Japanese study

Purpose. To compare treatment outcome results of conventional surgery vs. radiotherapy (RT) for carcinoma of the uterine cervix. Materials and methods. A retrospective analysis was conducted of 152 patients with uterine cervical cancer radically treated with surgery or high dose-rate intracavitary brachytherapy (HDR-ICBT) with or without external RT from June 1991 to May 2004. The median follow-up time was 43.5 months (range, 1.0-130.0 months). The median age was 53 years (range, 25-81 years). There were 13 patients (9%) in stage IA, 52 (34%) in stage IB, 24 (16%) in stage IIA, and 63 (41%) in stage IIB. The conventional surgery group included 115 patients (76%) who underwent hysterectomy with pelvic lymph node dissection. Of these, 72 (63%) received postoperative radiotherapy. Thirty-seven patients (24%) were assigned to the RT group. Of these, 14 (38%) received chemoradiotherapy. Three patients with stage I received ICBT-alone without external beam irradiation. Results. The 5-year cause-specific survival (CSS) rates for surgery and RT were 79.9% and 82.3%, respectively; the difference between these two treatments was not statistically significant (P = 0.8524). The differences in the survival rates between the two treatments for each of the stage I or stage II patients were also not statistically significant (P = 0.8407 for stage I and P = 0.6418 for stage II). Conclusions. This retrospective study suggests that RT results in compatible survival with conventional surgery for patients with stage I-II cervical carcinoma.