EVALUATING THE OUTCOMES OF ADJUVANT HYSTERECTOMY FOLLOWING RADIOTHERAPY AND CHEMOTHERAPY IN FEMALE ATHLETES WITH LOCALLY ADVANCED CERVICAL ADENOCARCINOMA

Abstract

Purpose: This study examines the clinical outcomes and safety of adjuvant hysterectomy following radical radiotherapy and chemotherapy in female athletes with locally advanced cervical adenocarcinoma. Methods: A retrospective review was conducted on 123 female athletes diagnosed with cervical adenocarcinoma from January 2005 to June 2010 at Jiangxi Maternal and Child Health Hospital. Twenty-five athletes underwent an extra fascial hysterectomy post-radical radiotherapy and chemotherapy (combined treatment group), while 98 continued with routine follow-ups post-radical radiotherapy and chemotherapy alone (radiotherapy and chemotherapy group). Survival outcomes and the impact of postoperative pathological factors on prognosis were analyzed. Results: The combined treatment group demonstrated a lower recurrence rate of 24% (6/25), compared to 54% (53/98) in the radiotherapy and chemotherapy group, with a statistically significant difference (P<0.05). The 3-year progression-free survival (PFS) and overall survival (OS) rates in the combined treatment group were superior at 75.6% and 80% respectively, compared to 48% and 52.1% in the radiotherapy and chemotherapy group. These differences were statistically significant with PFS [HR = 0.400 (95% CI 0.172-0.934), P = 0.034] and OS [HR 0.421 (95% CI 0.180-0.986), P = 0.046]. Long-term survival rates at 5 and 10 years in the combined treatment group were also favorable at 71.8% and 68% respectively. Importantly, the incidence of severe adverse reactions was comparable between the two groups, and the positive rate of postoperative pathology was 80%. Conclusion: Adjuvant hysterectomy following radical radiotherapy and chemotherapy in female athletes with locally advanced cervical adenocarcinoma significantly reduces pelvic recurrence and enhances overall survival rates without increasing the risk of severe complications. This suggests that a combined treatment approach may be particularly beneficial in managing cervical adenocarcinoma in athletic populations, where maintaining physical health and longevity is crucial.