Introduction Exclusive chemoradiation represents the standard of treatment for locally advanced cervical cancer (LACC). Chemoradiation (CT/RT) followed by radical surgery (RS) may play a role for patients with a suboptimal response to CT/RT. This study aimed to identify predictive factors for complete histological response after CT/RT followed by RS.

Methods We conducted a retrospective study at the Salah Azaiez Institute of Oncology from January 1, 2010, to December 31, 2020, including 118 patients with locally advanced cervical cancer treated with curative intentions. They underwent CT/RT followed by RS. Histologic assessment was made on the surgical specimen.

Results Among 118 operated after CT/RT; 52 had Radical hysterectomy with pelvic lymph node dissection(RHPND), 1 patient underwent RHPND with paraaortic lymph node dissection, 4 patients underwent Radical hysterectomy, and 2 patients had hysterectomy with pelvic lymph node dissection. 59 patients (50.4.%) presented complete responses on histological examination of the specimen. In our study, lymphovascular space involvement p (0.016)) was identified as a predictive factor for complete histologic response after CT/RT. In contrast, tumor size p (0.794), parametrial involvement p (0.382), histologic grade p (0.959), FIGO stage p (0.520), type of CT p (0.150) and dose of RT p (0.990) were not factors affecting complete histologic response to CT/RT.

Conclusion/Implications Lymphovascular space involvement was identified as a prognostic factor for complete response on the surgical specimen in locally advanced cervical cancer managed by CT/RT followed by surgery.