Prognosis of bulky pTIIB cervical cancer treated by radical hysterectomy comparing adenocarcinoma with squamous cell carcinoma using propensity score matching

OBJECTIVE: To investigate whether radical hysterectomy (RAH) can effectively treat true Stage IIB (pTIIB) cervical adenocarcinoma (AC) because FIGO (clinical) Stage IIB cervical cancer is rarely treated with RAH and radiotherapy has unfavorable effects on AC. METHODS: We retrospectively analyzed data for 82 patients with Stage pTIIB cervical cancer who underwent RAH at our institution between January 1997 and December 2017. The end points were disease‐free survival (DFS) and overall survival (OS) among squamous cell carcinoma (SCC) (n = 60) and AC (n = 22) patients. Kaplan–Meier survival analysis with and without propensity score matching was conducted to identify the impact of RAH. RESULTS: Para‐aortic lymph node metastasis and tumor diameter were significant factors for recurrence, and adjuvant chemotherapy prevented recurrence on multivariate analysis. After propensity score matching, there was no significant difference in DFS and OS between the groups. Five‐year DFS and OS of the SCC group were 0.505 (95% confidence interval [CI] 0.268–0.702) and 0.619 (95% CI 0.351–0.803), respectively, and those of the AC group were 0.444 (95% CI 0.232–0.638) and 0.602 (95% CI 0.351–0.782), respectively. CONCLUSION: Bulky Stage pTIIB cervical cancer is hard to cure, but RAH plus adjuvant therapy might be an option for radio‐resistant pTIIB cervical AC.