A 45-year-old woman undergoes radical hysterectomy and pelvic lymphadenectomy for Stage IB1 cervical squamous cell carcinoma. Final pathology shows deep stromal invasion (greater than one-third), lymphovascular space invasion, and tumor size 3.5 cm, but negative nodes and clear margins. According to the Sedlis criteria, which adjuvant therapy is indicated?

• A Observation only
• B Adjuvant brachytherapy alone
• C Adjuvant concurrent chemoradiation
• D Adjuvant external beam radiotherapy alone ✓

Explanation

The Sedlis criteria identify intermediate-risk factors for recurrence after radical hysterectomy: tumor size greater than 2 cm, deep stromal invasion (greater than one-third), and LVSI. Patients with any two of these factors benefit from adjuvant EBRT. Concurrent chemoradiation is reserved for high-risk features (positive nodes, positive margins, or parametrial involvement) per the Peters criteria.

Reference: Gynecologic Oncology, GOG 92/Sedlis trial ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.