Objectives To evaluate local control and survival of high risk cervical cancer patients submitted or not to vaginal cuff brachytherapy in the post-operative setting.

Methods Retrospective cohort of patients treated from 2010 to 2017. Patients were eligible if they had confirmed histological diagnosis of cervical cancer treated with surgery and adjuvant radiotherapy with or without chemotherapy. Vaginal cuff brachytherapy (VCB) was indicated according to the radiation oncologist discretion.

Results Seventy-nine patients were selected, with a median age at diagnosis of 47.5 years (26–77). Brachytherapy was delivered in 59 (74.7%). There were no significant differences between the VCB and the no-VCB groups. A total of 13 (16.5%) patients presented one or more events, 5 (25%) and 8 (13.5%) events in the no-VCB and VCB group, respectively. Most recurrences were pelvic and/or vaginal: 7/20 (35%) in the no-VCB group and 9/59 (10.2%) in the VCB group. There were 8 systemic relapses with 8 deaths. With a median follow-up of 45 months, median overall and disease-free survival were, respectively, 85.1 and 83.8 months. No variables were correlated with overall survival. The only factor positively correlated to disease-free survival was VCB, with a mean of 86.9 and 68.4 months for patients that did and did not receive it, respectively (p=0.043). Vaginal recurrence was lower in the brachytherapy group, but with no significance (p=0.065).

Conclusions VCB was associated with a reduced recurrence rate in the post-operative setting of high-risk early stage cervical cancer patients.