Adjuvant therapy following primary surgery in earlystage carcinoma

A. Patients with histologically documented extracervical disease (pelvic nodal involvement, positive margins, or parametrial extension) are treated with concurrent pelvic radiation therapy and cisplatin-based chemotherapy. The use of combined adjuvant chemotherapy and radiation therapy in these high-risk patients following primary surgery significantly improves relapse-free survival and overall survival rates when compared with radiation therapy alone.

B. Following radical hysterectomy, a subset of node-negative patients who have a constellation of primary risk factors (large tumors, depth of stromal infiltration, and lymphovascular space involvement) may be defined as having intermediate risk for relapse. For these patients, adjuvant pelvic radiation therapy provides clear therapeutic benefit, with significantly improved relapse-free survival rates when compared with those who had no further therapy.

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