Introduction/Background Dual modality treatment in cervical cancer is associated with increased morbidity. This study was conducted to understand the surgical-pathological factors associated with adjuvant treatment, following RH (Radical Hysterectomy), in early-stage cervical cancer (ESCC).

Methodology Single centre retrospective observational study was conducted in a tertiary care cancer centre in India. ESCC patients, who underwent primary surgical treatment between 2011 and 2022, were included.

Results 64 ESCC patients underwent RH. Total 32(50%) patients needed adjuvant treatment; 13(20.3%) due to one or more high risk factors (HRF) positivity, received concurrent chemo-radiotherapy; 17(26.6%) due to intermediate risk factors (IRF) positivity, received adjuvant RT (Radiotherapy) and 2 patients with final histology of NET (Neuro-Endocrine Tumour) were given adjuvant CT (Chemotherapy). Total 28(46.7%) patients had IRF, as 11 patients, who were positive for HRF, were also positive for IRF. Among patients who had HRF; 11 had LN (Lymph Node) positivity, 3 had parametrium positivity and 4 had margin positivity. We started routine frozen evaluation of LN from September, 2019, and those who had negative frozen LN frozen were proceeded with RH. For a total of 31 ESCC patients, intra-operative frozen LN assessment was done and was found negative in 20 patients. All frozen negative LN were also negative in final pathology. 11 (17% of total cohort) patients underwent pre-operative electro surgical DEP (Diagnostic Excision Procedure) and among them only one (9.9% of 11) had positive IRF in final pathology. In cohort of diagnostic punch biopsy, 27 (50.94% of 53) patients had positive IRF in final pathology. Difference in IRF positivity rates between DEP and punch biopsy groups was significant (p-0.026).

Conclusion Routine practice of pre-operative DEP to know IRF and pre-operative or intra-operative LN assessment by histological or frozen assessment respectively, can help to avoid dual modality of treatment in significant number of ESCC patients.

Disclosures No conflict of interests