Intermediate‑risk factors affecting oncological outcome in patients with FIGO 2018 stage IB2 cervical cancer who do not receive adjuvant therapy

Abstract

The objective of the present study was to examine how intermediate‑risk factors affect the oncological outcomes of patients diagnosed with International Federation of Gynecology and Obstetrics (FIGO) 2018 stage IB2 cervical cancer who do not undergo any adjuvant treatment. A multi‑ centric retrospective study that involved 612 patients who were diagnosed with stage IA‑IB2 cervical cancer at seven tertiary gynaecological oncology centres between 1993 and 2023 was conducted. A total of 232 patients were classified as FIGO 2018 stage IB2. Patients who had received neoadjuvant chemotherapy, parametrial or surgical border involvement, received adjuvant therapy and synchronous tumours were excluded from the present cohort. Therefore, the present study cohort consisted of 120 patients who had undergone radical hysterectomy and lymphadenectomy. Among the 120 patients, 89 (74.2%) had squamous cell cancer, 18 (15%) had adeno‑ carcinoma, 2 (1.7%) had a mixed type tumour consisting of squamous cell cancer and adenocarcinoma and 11 (9.1%) had other types of tumours (adenosquamous cancer and glassy cell cancer). Deep cervical stromal invasion was found in 68 (56.7%) patients. The duration of patient follow‑up varied from 1 to 246 months, with a median of 36 months. Overall, 6 patients (5%) experienced recurrence and 1 patient (0.8%) succumbed to the disease. The 3‑year disease‑free survival (DFS) rate was 94%, whereas the 3‑year overall survival rate was 99%. The presence of deep cervical stromal invasion had a statistically significant impact on DFS (P=0.038). Deep cervical stromal invasion was found to be associated with recurrence in patients with stage IB2 cervical cancer. Hence, the present study demonstrated that the presence of deep cervical stromal invasion may be considered a key parameter in determining whether adjuvant treatment should be applied in patients with stage IB2 cervical cancer. © 2025 Elsevier B.V., All rights reserved.