A 35-year-old woman undergoes radical hysterectomy for Stage IB1 cervical squamous cell carcinoma. Final pathology shows deep stromal invasion (more than two-thirds), lymphovascular space invasion, and tumor size of 3.5 cm with negative margins and negative nodes. Which adjuvant treatment is indicated based on the GOG criteria (Sedlis criteria)?

• A Adjuvant external beam radiotherapy alone ✓
• B No adjuvant treatment; surveillance only
• C Adjuvant concurrent chemoradiation with cisplatin
• D Adjuvant chemotherapy alone

Explanation

This patient meets the Sedlis criteria (intermediate-risk factors) for adjuvant radiotherapy: more than one-third stromal invasion, LVSI, and tumor size greater than 2 cm (intermediate risk requires at least two of these three factors). Adjuvant external beam radiotherapy alone reduces pelvic recurrence in this population. Concurrent chemoradiation is reserved for high-risk features (positive nodes, positive margins, or parametrial invasion) per the Peters criteria.

Reference: NCCN Guidelines: Cervical Cancer

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Written and medically reviewed by the StethoPrep medical team.