摘要：The aim of this study was to investigate the impact of local treatment modalities on the survival of patients with International Federation of Gynecology and Obstetrics (FIGO) stage IB-IIB cervical cancer, including cancer-directed surgery (CDS) alone and CDS combined with radiotherapy (RT). A total of 8,357 patients with cervical cancer between 1988 and 2013 were included in the final study cohort, including 4,298 (51.4%) patients who underwent CDS alone and 4,059 (48.6%) patients who received combination therapy. Univariate and multivariate analyses showed that local treatment modalities were prognostic factors for cause-specific survival (CSS). Patients who received combination therapy had worse CSS (HR = 1.38; 95% CI = 1.20-1.59; P < 0.001). Subgroup analyses showed the prognostic effect of local treatment modalities was significantly influenced by FIGO stage. In the propensity-score matched (PSM) dataset, CDS was associated with better CSS (P < 0.001) for patients with IB-IIA cervical cancer; nevertheless, no differences were observed in CSS (P = 0.639) for patients with IIB cervical cancer. In conclusion, radical surgery was the preferred treatment for patients with IB-IIA cervical cancer, and there was no difference between radical surgery alone and combination therapy for patients with IIB cervical cancer.
