Introduction/Background The therapeutic approach for locally advanced cervical cancer it’s different from the ESGO-ESTRO recommendations. Curative chemoradiotherapy is not routinely performed, but an induction chemoradiotherapy is administered with external radiotherapy (50 Gy), brachytherapy (15 Gy), and radiosensitizing chemotherapy. Surgical intervention is performed 6–8 weeks after the completion of chemoradiotherapy if there are clinical and imaging criteria for operability.

The objective is to determine the role of surgical intervention in relation with chemoradiotherapy for the treatment of patients with stages IB3-IIIB cervical cancer, based on our own experience.

Methodology Our analysis included a cohort of 351 women diagnosed with stage IB3-IIIB cervical cancer, who received treatment at the Institute of Oncology Bucharest between January 2015 and December 2021.

The treatment protocol was represented by: whole pelvis external beam radiation with total dose=50.4 Gy; two high dose rate brachytherapy with total dose= 15 Gy to point A; Cisplatin- 40 mg/m² weekly for a total of 5 doses. After 6–8 weeks laparotomy, followed by C2 type radical hysterectomy.

Results The local control rate ranges between 70–80%, yielding the most favorable outcomes in terms of patient survival. However, a significant concern remains regarding the delay between the histopathological diagnosis and the initiation of radiotherapy treatment, with an average waiting time of 2–3 months in Romania.The combined approach of chemoradiotherapy and surgery resulted in various complications in 49 cases (14%) of the total patient cohort.

Conclusion The true significance of residual tumor after chemoradiation in terms of prognosis for cervical cancer remains uncertain. In Romania, surgery is conducted following chemoradiation with a total radiation dose of 65–70 Gy to improve local control and continues to hold a significant role in the management of locally advanced cervical cancer. This approach remains relevant until radiotherapists are able to administer curative doses.

Disclosures No disclosures