Background/Objectives: Cervical cancer (CC) is the fourth most common gynecologic malignancy, disproportionately affecting women in low- and middle-income countries. Despite the effectiveness of HPV vaccination and screening strategies, CC poses a major global health issue, accounting for approximately 94% of annual deaths. Τhis review aims to summarize the current evidence regarding adjuvant treatment indications for surgically treated cervical cancer patients and identify areas where further research is required. Methods: After a literature search, a comprehensive review of the existing guidelines, clinical trials, and cohort studies related to cervical cancer treatment was conducted, focusing on the role of adjuvant therapy in patients classified as at low, intermediate, and high risk for recurrence, who may require no further treatment. Results: Adjuvant therapy is generally unnecessary for low-risk patients, while high-risk patients with lymph node invasion, parametrial involvement, or large tumor size require chemoradiation (CRT). Ιntermediate-risk patients fall into a grey zone, where the necessity of adjuvant therapy is still debatable. Guidelines emphasize the need for individualization in treatment strategies, since, based on the published studies, careful surgery alone and observation can provide similar outcomes to adjuvant therapy. Conclusions: This review emphasizes that achieving monotherapy remains pivotal to optimize outcomes and minimize overtreatment. Definitive adjuvant treatment is indicated for high-risk cases, and intermediate-risk patients may benefit from careful observation following adequate surgical intervention, pointing out the necessity of well-designed clinical trials.
背景/目的：宫颈癌是全球第四常见的妇科恶性肿瘤，对中低收入国家女性影响尤为显著。尽管HPV疫苗接种和筛查策略已证实有效，宫颈癌仍是重大全球公共卫生问题，约占全球女性年度死亡病例的94%。本综述旨在系统总结当前关于宫颈癌手术患者辅助治疗适应证的循证依据，并明确需要进一步研究的领域。方法：通过文献检索，对现有宫颈癌治疗相关指南、临床试验及队列研究进行全面综述，重点关注不同复发风险分层（低危、中危、高危）患者中辅助治疗的作用，其中部分患者可能无需进一步治疗。结果：低危患者通常无需辅助治疗；而存在淋巴结转移、宫旁浸润或肿瘤体积较大等高危特征的患者需行放化疗。中危患者处于治疗决策的灰色地带，辅助治疗的必要性仍存争议。现有指南强调治疗策略需个体化，因为已发表研究表明，对于特定患者，精细手术联合密切观察可获得与辅助治疗相似的预后。结论：本综述强调实现单模式治疗对优化疗效、避免过度治疗至关重要。高危病例需明确进行辅助治疗，而中危患者在充分手术干预后可能从密切观察中获益，这提示未来需要开展设计严谨的临床试验加以验证。
Adjuvant Treatment for Surgically-Treated Cervical Cancer Patients: A Comprehensive Review
肿瘤(癌症)患者之家