Objectives The aim of this study was to evaluate the surgical morbidity and oncologic results on patients undergoing completion surgery for locally advanced-stage cervical cancer after initial concurrent chemo-radiotherapy (CCR).

Methods It is a retrospective case/control study including all patients from 01/01/2000 to 31/12/2014 with advanced cervical cancer (stage IIB–IVA) treated with CCR (45 Gray pelvic external radiation therapy with concomitant chemotherapy (Cisplatin 40 mg/m² per week) followed or not by uterovaginal brachytherapy) followed or not by surgery. Disease-free and overall survival rates at 3 and 5 years were compared.

Results We included 170 patients of whom 50 had CCR and catch-up surgery and 120 only CCR The two groups were comparable in terms of age at diagnosis, socio-economic characteristics of the patients, characteristics of the disease at diagnosis and after CCR. Hysterectomy was extra-fascial in 66% of cases. It was laparoscopic in 6% of cases. Pelvic lymphadenectomy was performed in 20% of cases. The operative complication rate was 23% with 12 immediate complications in 8 patients. The reoperation rate was 6%. The recurrence rate was 96% in the exclusive RCC group versus 66% in the surgery group with a significant difference in favor of surgery (p < 0.0001). The overall survival at 5 years after surgery was 55% versus 16% in the control group with a significant difference in favor of surgery (p < 0.0001).

Conclusions The therapeutic impact of surgery based on completion hysterectomy with or without pelvic lymphadenectomy after CCR for locally advanced cervical cancer improved local disease control, overall and recurrence-free survival.