FIGO stage 1B2 cervical carcinoma: The KK Women's and Children's Hospital experience

Introduction: The objectives of this review were to document the surgicopathological characteristics of surgically resected FIGO stage IB2 cervical carcinoma and to review our overall experience with this disease. Materials and Methods: This is a retrospective review of 35 patients diagnosed and treated from September 1990 to November 2001. Results: The median age was 42 years and the mean tumour diameter was 5.1 cm. Majority were squamous cell carcinomas (65.7%), 28.6% were adenocarcinomas and 5.7% were adeno-squamous carcinomas. The primary treatment comprised radical surgery in 77.1%, radiotherapy in 20% and neoadjuvant chemotherapy followed by radical surgery and adjuvant radiotherapy in 2.9%. Significant surgicopathological features noted were deep stromal invasion (66.7%), lymphovascular space invasion (55.6%), parametrial involvement (22.2%), positive margins (3.7%) and pelvic node metastases (33.3%). Postoperative radiation was given to 92.6% of the patients who underwent primary surgery, of whom 29% received concurrent chemotherapy. Radiation toxicity was mild with no grade 3 or 4 toxicity documented. For the patients who had surgery, the recurrence rate was 14.8% (11.1% pelvic and 3.7% distant) and the survival rate was 88.9%. For those who had primary radiation, the rate of persistent disease was 28.6%, the distant recurrence rate was 28.6% and the survival rate was 57.1%. Conclusion: FIGO stage 1B2 cervical carcinomas are associated with significant rates of adverse surgicopathological features. The ideal primary treatment is yet to be established and should be determined by prospective randomised trials.