Postoperative management of FIGO 2018 stage IIA1 cervical squamous cell carcinoma with only one intermediate‐risk factor: Is radiotherapy needed?

Abstract Objective To investigate whether postoperative radiotherapy is required for FIGO 2018 stage IIA1 cervical squamous cell carcinoma patients with only one intermediate‐risk factor. Methods This was a multicenter retrospective study. The selected patients were classified into no postoperative adjuvant therapy and postoperative radiotherapy groups. The 5‐year overall survival (OS) and disease‐free survival (DFS) rates were compared. Results In total, 159 patients with no postoperative adjuvant therapy and 179 patients with postoperative radiotherapy were included, with the former group showing a lower OS but no difference in DFS. No postoperative adjuvant therapy was an independent risk factor for patient mortality. Patients were also stratified by tumor diameter: 56 patients had a tumor diameter ≤2 cm, comprising 32 patients with postoperative radiotherapy and 24 patients without (no between‐group difference was found); 272 patients had a tumor diameter >2 cm, comprising 122 patients with postoperative radiotherapy and 150 patients without, with the former group showing a higher OS, and no postoperative adjuvant therapy was an independent risk factor for patient mortality. Conclusion For FIGO 2018 stage IIA1 cervical squamous cell carcinoma patients with only one intermediate‐risk factor and a tumor diameter >2 cm, postoperative radiotherapy is likely beneficial to improve prognosis.