Management of Stage IIB Cervical Cancer: an Overview of the Current Evidence

Purpose of Review To review and discuss the present evidence of surgery- and radiation-based treatment strategies for stage IIB cervical cancer. Recent Findings Recently, two randomized controlled trials compared the efficacy of neoadjuvant chemotherapy followed by radical hysterectomy (NACT + RH) w...

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Bibliographic Details
Published in:Current oncology reports 2020-02, Vol.22 (3), p.28-28, Article 28
Main Authors: Matsuzaki, Shinya, Klar, Maximilian, Mikami, Mikio, Shimada, Muneaki, Grubbs, Brendan H., Fujiwara, Keiichi, Roman, Lynda D., Matsuo, Koji
Format: Article
Language:English
Subjects:
Adenocarcinoma - pathology
Adenocarcinoma - therapy
Antineoplastic Agents - therapeutic use
Cancer therapies
Carcinoma, Adenosquamous - pathology
Carcinoma, Adenosquamous - therapy
Carcinoma, Squamous Cell - pathology
Carcinoma, Squamous Cell - therapy
Cervical cancer
Cervix
Chemoradiotherapy
Chemotherapy
Combined Modality Therapy
Female
Gynecologic Cancers (NS Reed
Humans
Hysterectomy
Hysterectomy - methods
Medicine
Medicine & Public Health
Neoadjuvant Therapy
Neoplasm Staging
Oncology
Practice Guidelines as Topic
Prognosis
Randomized Controlled Trials as Topic
Section Editor
Surgery
Survival
Topical Collection on Gynecologic Cancers
Uterine Cervical Neoplasms - pathology
Uterine Cervical Neoplasms - therapy
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Summary:Purpose of Review To review and discuss the present evidence of surgery- and radiation-based treatment strategies for stage IIB cervical cancer. Recent Findings Recently, two randomized controlled trials compared the efficacy of neoadjuvant chemotherapy followed by radical hysterectomy (NACT + RH) with that of concurrent chemoradiotherapy (CCRT) for stage IB3–IIB cervical cancer. When these studies were combined ( N  = 1259), NACT + RH was associated with a shorter disease-free survival [hazard ratio (HR) 1.36, 95% confidence interval (CI) 1.13–1.64], but with a similar overall survival (HR 1.11, 95% CI 0.90–1.36) when compared with the findings for CCRT. Stage-specific analysis for stage IIB cervical cancer demonstrated that disease-free survival was significantly worse with NACT + RH than with CCRT (HR 1.90, 95% CI 1.25–2.89); however, no significant difference was observed for stage IB3–IIA cervical cancer. Summary Based on the results of recent level I evidence, the standard treatment for stage IIB cervical cancer remains CCRT.
ISSN:1523-3790
1534-6269
DOI:10.1007/s11912-020-0888-x