ArticleAJOG global reports2026
Preoperative prediction of the need for postoperative adjuvant therapy in stage IB cervical cancer using tumor size measured on magnetic resonance imaging and serum squamous cell carcinoma antigen levels.
Article in AJOG global reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveRadical hysterectomy is widely performed for stage IB cervical cancer; however, a substantial number of patients require postoperative adjuvant therapy, resulting in dual-modality treatment. This study evaluated the predictive value of tumor size measured on magnetic resonance imaging (MRI) and serum squamous cell carcinoma (SCC) antigen levels for the need for postoperative adjuvant therapy.
methodsWe retrospectively analyzed 191 patients with stage IB cervical SCC who underwent radical hysterectomy. Patients were also analyzed in a stage IB1 to IB2 cohort. The cut-off values of preoperative tumor size measured on MRI and serum SCC antigen levels for the need for postoperative adjuvant therapy were determined using receiver operating characteristic curve analysis.
resultsA total of 104 patients (54.5%) received postoperative adjuvant therapy. Large tumor size measured on MRI and elevated serum SCC antigen levels were predictors of the need for postoperative adjuvant therapy. The optimal cut-off values were 3.2 cm and 2.3 ng/mL in the overall cohort, and 2.4 cm and 2.3 ng/mL in the stage IB1 to IB2 cohort. Patients were stratified into three risk groups according to the number of predictive factors. In the low-risk group (no predictors), 20 of 86 patients (23.3%) required postoperative adjuvant therapy. In the intermediate-risk group (one predictor), 46 of 64 patients (71.9%) required adjuvant therapy. In the high-risk group (two predictors), 38 of 41 patients (92.7%) received adjuvant therapy. Similar trends were observed in the stage IB1 to IB2 cohort, with increasing rates of adjuvant therapy across risk groups.
conclusionPreoperative tumor size measured on MRI and serum SCC antigen levels are useful predictors of the need for postoperative adjuvant therapy in stage IB cervical SCC. Their combination could assist in treatment planning and patient counseling.
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