Introduction/Background This study was performed to evaluate the morbidity and therapeutic value of surgery after concurrent chemoradiotherapy and brachytherapy in patients with locally advanced cervical cancer (LACC).

Methodology We conducted a retrospective study at Salah Azaiez Institute of Oncology from January 1, 2010, to December 31, 2020, including 118 patients with LACC treated with concurrent chemoradiotherapy and pelvic radiotherapy followed by brachytherapy. The surgical treatment consisted of a hysterectomy, which ranged from radical hysterectomy to anterior pelvic exenteration, and lymph node resection.

Results 118 patients were enrolled over 10 years. The median age was 53 years±10.758. Patients’ distribution according to FIGO stage was as follows: 72 (61%) patients ≤IIB and 46 (39%)>IIB. Among these patients, 49 (41.5%) experienced postoperative complications. 9 patients experienced Grade II morbidity while 18 patients presented Grade III morbidity. No postoperative mortality was observed. The median operative time was 215.59 min ±68.7. The median duration of hospitalization was 6.12 days ±15.7. 41 patients (34.7%) needed per-operative transfusions. The median number of packed red blood cells was 2.46 ±1.12. 39 patients presented preoperative complications. Per-operative bleeding was the most common complication observed in 38 cases.

Personal history of High blood pressure (p=0.0149), tumor size (p=.0.051), and pelvic anterior exenteration (p=0.037) were risk factors of postoperative morbidity.

Post-operative morbidity was not significantly different for age (p=0.781), FIGO stage (p=0.969), and per-operative transfusion (p=0.799).

Conclusion Surgery after concurrent chemoradiotherapy and brachytherapy for advanced cervical cancer lead to an acceptable morbidity. In our study, Personal history of High blood pressure, tumor size, and pelvic anterior exenteration were risk factors for postoperative morbidity.

Disclosures We have no potential conflict of interest to report.