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

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Abstract

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.

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Funding

This study is supported by Ensign Endowment for Gynecologic Cancer Research (K.M.).

Author information

Correspondence to Koji Matsuo.

Ethics declarations

Conflict of Interest

Shinya Matsuzaki has received research funding from MSD.

Maximilian Klar has served on advisory boards for Tesaro and GlaxoSmithKline.

Mikio Mikami declares that he has no conflict of interest.

Muneaki Shimada declares that he has no conflict of interest.

Brendan H. Grubbs declares that he has no conflict of interest.

Keiichi Fujiwara has received research funding from Kaken, Shionogi, AstraZeneca, Pfizer, Eisai, MSD, Taiho Oncology, Zeria, Chugai, GlaxoSmithKline, Eli Lilly, ImmunoGen, OncoTherapy Science, Regeneron, and Genmab; and has received compensation from AstraZeneca, Pfizer, Eisai, MSD, Taiho Oncology, Zeria, Chugai, Nihon Kayaku, Novartis, Kyowa Hakko Kirin, Janssen, Daiichi Sankyo, Mochida, and Genmab for service as a consultant.

Lynda D. Roman has received compensation from Tempus and Quantgene for service as a consultant.

Koji Matsuo has received honoraria from Chugai; a textbook editorial expense from Springer; and reimbursement for investigator meeting attendance expenses from VBL Therapeutics.

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This article is part of the Topical Collection on Gynecologic Cancers

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Matsuzaki, S., Klar, M., Mikami, M. et al. Management of Stage IIB Cervical Cancer: an Overview of the Current Evidence. Curr Oncol Rep 22, 28 (2020). https://doi.org/10.1007/s11912-020-0888-x

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Keywords

  • Cervical cancer
  • Stage II
  • Concurrent chemoradiotherapy
  • Neoadjuvant chemotherapy
  • Radical hysterectomy
  • Survival