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#146 Non-surgical management of locally advanced cervical cancer: a tunisian experience
  1. Ines Houissa,
  2. Azza Chabchoub,
  3. Lamia Naija,
  4. Amani Jellali,
  5. Montassar Ghalleb,
  6. Ines Zemni,
  7. Maher Slimane and
  8. Tarak Ben Dhieb
  1. Salah Azaiez Institute, Tunis, Tunisia


Introduction/Background Concurrent chemoradiotherapy(CCRT) is the standard-of-care treatment for locally advanced cervical cancer(LACC) and complete response(CR) is achieved in 70%–90% of patients. Surgery after CR is still debated .Is definitive CCRT recommended in our population?

Methodology We retrospectively reviewed the clinical record of 22 patients treated for LACC by definitive CCRT between 2011 and 2021.

Results The mean age of patients at diagnosis was 55.5 years old .

Patients were staged as stage IB3, IIA, IIB, III to stage IV in 9.1%, 13.6%, 36.4%, 31.7% and 9.1% of cases respectively.

All subjects received CCRT followed by brachytherapy.

Response after CRRT, evaluated by a magnetic resonance imaging (MRI) and cervical biopsy, was complete in all cases.

Six patients presented with a loco-regional relapse (LRR) respectively on pelvic lymph nodes (3cases), uterine cervix (2cases), and on the vagina. The relapses occurred in the first 18 months in 5 cases. One patient had a late LRR after 45 months of follow-up.

Three of them underwent surgery with an R0 resection while the other ones received palliative chemotherapy. One patient presented after 13 months of follow-up with bone metastasis that was treated by exclusive external radiotherapy.

Clinical factors correlated with LRR were pelvic nodal status on MRI (p<0.01), bladder involvement on MRI (p<0.035) and clinical tumor stage (p<0.047).

However age, tumor size, histological type and the presence of lympho-vascular invasion were not significantly related to the risk of LRL .

The average duration of follow-up was 27.05 months.

The 2-year OS rate was 76.4% visualized in Kaplan–Meier curves; however, the disease-free survival rate was about 85.9% for all cases in 2 years.

Conclusion To date no study has attested of a significantly improved OS and DFS after completion surgery.

A prospective randomized trial is mandatory to compare the two approaches and to evaluate the morbidity and survival outcome.

Disclosures The authors have nothing to disclose.

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