宫颈癌中危患者（CC-IR）辅助治疗的疗效仍存在争议。我们研究了辅助治疗对CC-IR患者生存结局的影响，并根据临床病理特征评估了辅助治疗的异质性治疗效应（HTEs）。我们对之前日本全国范围内的6192例行子宫全切术的IB-IIB期宫颈癌患者进行了回顾性分析。我们创建了两对配对倾向分数匹配的治疗组/对照组，以研究辅助治疗的治疗效果：（1）辅助治疗与非辅助治疗比较；（2）在辅助治疗条件下，化疗与放疗比较。进行多变量分析与治疗交互作用，以评估HTEs。 在1613例CC-IR患者中，非治疗组和治疗组分别有619例和994例。两组之间的生存结局没有差异：3年进展无病生存率（PFS）分别为88.1%和90.3%（p=0.199）。在治疗组中，654例接受放疗，340例接受化疗。接受化疗的患者的PFS较接受放疗的患者好（3年PFS分别为90.9%和82.9%，p=0.010）。肿瘤大小是影响化疗治疗效果的重要因素，大肿瘤的患者从化疗中获得的治疗效果较小肿瘤的患者更好。 对于一些CC-IR患者，辅助治疗是可选的；但是，化疗可以作为辅助治疗推荐，尤其适用于肿瘤较大的患者。 ©2023年该论文作者。由John Wiley＆Sons Ltd出版的Cancer Medicine刊物发表。

The efficacy of adjuvant therapy for patients with cervical cancer with intermediate risk (CC-IR) remains controversial. We examined the impact of adjuvant therapy on survival outcomes in patients with CC-IR and evaluated the heterogeneous treatment effects (HTEs) of adjuvant therapies based on clinicopathologic characteristics.We retrospectively analyzed a previous Japanese nationwide cohort of 6192 patients with stage IB-IIB cervical cancer who underwent radical hysterectomy. We created two pairs of propensity score-matched treatment/control groups to investigate the treatment effects of adjuvant therapies: (1) adjuvant therapy versus non-adjuvant therapy; (2) chemotherapy versus radiotherapy conditional on adjuvant therapy. Multivariate analyses with treatment interactions were performed to evaluate the HTEs.Among the 1613 patients with CC-IR, 619 and 994 were in the non-treatment and treatment groups, respectively. Survival outcomes did not differ between the two groups: 3-year progression-free survival (PFS) rates were 88.1% and 90.3% in the non-treatment and treatment groups, respectively (p = 0.199). 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-year PFS, 90.9% vs. 82.9%, p = 0.010). 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.Adjuvant therapy is optional for some patients with CC-IR; however, chemotherapy can be recommended as adjuvant therapy, particularly for patients with large tumors.© 2023 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.