{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T16:24:00Z","timestamp":1776788640661,"version":"3.51.2"},"reference-count":27,"publisher":"Wiley","issue":"18","license":[{"start":{"date-parts":[[2023,8,16]],"date-time":"2023-08-16T00:00:00Z","timestamp":1692144000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The efficacy of adjuvant therapy for patients with cervical cancer with intermediate risk (CC\u2010IR) remains controversial. We examined the impact of adjuvant therapy on survival outcomes in patients with CC\u2010IR and evaluated the heterogeneous treatment effects (HTEs) of adjuvant therapies based on clinicopathologic characteristics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively analyzed a previous Japanese nationwide cohort of 6192 patients with stage IB\u2013IIB cervical cancer who underwent radical hysterectomy. We created two pairs of propensity score\u2010matched treatment\/control groups to investigate the treatment effects of adjuvant therapies: (1) adjuvant therapy versus non\u2010adjuvant therapy; (2) chemotherapy versus radiotherapy conditional on adjuvant therapy. Multivariate analyses with treatment interactions were performed to evaluate the HTEs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among the 1613 patients with CC\u2010IR, 619 and 994 were in the non\u2010treatment and treatment groups, respectively. Survival outcomes did not differ between the two groups: 3\u2010year progression\u2010free survival (PFS) rates were 88.1% and 90.3% in the non\u2010treatment and treatment groups, respectively (<jats:italic>p<\/jats:italic>\u2009=\u20090.199). Of the patients in the treatment group, 654 and 340 received radiotherapy and chemotherapy, respectively. Patients who received chemotherapy had better PFS than those who received radiotherapy (3\u2010year PFS, 90.9% vs. 82.9%, <jats:italic>p<\/jats:italic>\u2009=\u20090.010). Tumor size was a significant factor that affected the treatment effects of chemotherapy; patients with large tumors gained better therapeutic effects from chemotherapy than those with small tumors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Adjuvant therapy is optional for some patients with CC\u2010IR; however, chemotherapy can be recommended as adjuvant therapy, particularly for patients with large tumors.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cam4.6460","type":"journal-article","created":{"date-parts":[[2023,8,19]],"date-time":"2023-08-19T05:33:14Z","timestamp":1692423194000},"page":"18557-18567","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Heterogeneous treatment effects of adjuvant therapy for patients with cervical cancer in the intermediate\u2010risk group"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5491-3871","authenticated-orcid":false,"given":"Ayumi","family":"Taguchi","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Graduate School of Medicine The University of Tokyo  Tokyo Japan"},{"name":"Gynecology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kosuke","family":"Kato","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Graduate School of Medicine The University of Tokyo  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Konan","family":"Hara","sequence":"additional","affiliation":[{"name":"Department of Economics University of Arizona  Tucson Arizona USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akiko","family":"Furusawa","sequence":"additional","affiliation":[{"name":"Gynecology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital  Tokyo Japan"},{"name":"Department of Gynecology Shizuoka Cancer Center Hospital  Shizuoka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yujiro","family":"Nakajima","sequence":"additional","affiliation":[{"name":"Department of Radiological Sciences Komazawa University  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chihiro","family":"Ishizawa","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Graduate School of Medicine The University of Tokyo  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michihiro","family":"Tanikawa","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Graduate School of Medicine The University of Tokyo  Tokyo Japan"},{"name":"Gynecology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenbun","family":"Sone","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Graduate School of Medicine The University of Tokyo  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mayuyo","family":"Mori","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Graduate School of Medicine The University of Tokyo  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1826-6723","authenticated-orcid":false,"given":"Muneaki","family":"Shimada","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Tohoku University School of Medicine  Sendai Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aikou","family":"Okamoto","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology The Jikei University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0807-1845","authenticated-orcid":false,"given":"Munetaka","family":"Takekuma","sequence":"additional","affiliation":[{"name":"Department of Gynecology Shizuoka Cancer Center Hospital  Shizuoka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,8,16]]},"reference":[{"key":"e_1_2_12_2_1","unstructured":"National Cancer Registry (Ministry of Health Labour and Welfare) tabulated by National Cancer Center Japan Cancer Information Service. 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