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EPV085/#566 Is a ‘catch up’ surgery after chemoradiation therapy for locally advanced cervical cancer still an option?
  1. O Kaabia,
  2. R Bouchahda,
  3. S Hidar and
  4. M Bibi
  1. Université de Sousse, Faculté de Médecine de Sousse, Gynecology and Obstetrics, Sousse, Tunisia


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.

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