Prognostic significance of poorly differentiated histology and impact of adjuvant chemotherapy in early squamous cell carcinoma of cervix uteri

Abstract

Objective: This study is to determine whether the addition of cisplatin-based chemotherapy after radical hysterectomy will improve the survival of low-risk squamous cervical carcinoma with poor differentiation. Methods: Patients with low-risk squamous cervical cancer (FIGO IA2–IIA, absent high- and intermediate-risk factors after pathological evaluation) were eligible for this study. As first, the prognostic relevance of G3 versus G1/G2 among patients with low-risk squamous cervical cancer was analyzed, then, the oncological results of postoperative chemotherapy among low-risk squamous cervical cancer with poor differentiation was explored. Results: Totally, there were 367 low-risk squamous cervical cancer patients, of whom 161 were poor-differentiated (47 in the chemotherapy group and 114 in the nonchemotherapy group), with a median follow-up time of 56 months. Patients with G3 displayed a significantly worse overall survival (p = 0.035), and a higher recurrence rate (p = 0.014) than patients with G1/G2. Compared with the nonchemotherapy group, the hazard ratios (95%CI) for recurrence-free survival in the chemotherapy group was 0.24 (0.06–0.93), (p = 0.038). No difference in overall survival was observed between the chemotherapy group and the nonchemotherapy group. Conclusions: The addition of cisplatin-based chemotherapy following surgery significantly improved recurrence-free survival for low-risk, poor differentiation, and early stage squamous cervical cancer patients.