Comparison of adjuvant therapy for node‐positive clinical stage IB‐IIB cervical cancer: Systemic chemotherapy versus pelvic irradiation

This was a nation‐wide retrospective study in Japan examining women who underwent radical hysterectomy for clinical stage IB–IIB cervical cancer with pelvic and/or para‐aortic lymph node metastasis between 2004 and 2008. Time to recurrence or death and patterns of disease recurrence were compared based upon the adjuvant treatment pattern: whole pelvic radiotherapy alone (n = 253), concurrent chemoradiotherapy (CCRT, n = 502) and chemotherapy alone (n = 319). Women who received chemotherapy alone had similar recurrence (5‐year rates, 36.6% vs. 34.1%, adjusted‐hazard ratio [HR] 0.95, 95% confidence interval [CI] 0.70–1.28, P = 0.72) and cervical cancer mortality (24.7% vs. 21.8%, adjusted‐HR 0.96, 95% CI 0.67–1.38, P = 0.83) rates compared to those who received CCRT on multivariate analysis. However, when recurrence patterns were stratified, chemotherapy treatment was independently associated with decreased risk of distant recurrence (5‐year cumulative rates, 19.2% vs. 24.6%, adjusted‐HR 0.47, 95% CI 0.31–0.71, P