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827 The role of surgical management in advanced cervical cancer with persistent or recurrent disease following definitive chemoradiotherapy
  1. Mustafa Onur Kamani1,
  2. Nüseybe Artiran2,
  3. Neslihan Discioglu2,
  4. Ferah Yildiz3,
  5. Melis Gültekin3,
  6. Sezin Yüce Sari3,
  7. Ecem Yigit3,
  8. Murat Gültekin4 and
  9. Nejat Özgül4
  1. 1Bartin State Hospital, Department of Obstetrics and Gynecology, Bartin, Turkey
  2. 2Hacettepe University Faculty of Medicine, Department of Obstetrics and Gynecology, Ankara, Turkey
  3. 3Hacettepe University Faculty of Medicine, Department of Radiation Oncology, Ankara, Turkey
  4. 4Hacettepe University Faculty of Medicine, Division of Gynecologic Oncology, Ankara, Turkey


Introduction/Background Cervical cancer,often diagnosed at a locally advanced stage, is typically treated with chemoradiotherapy (CRT) followed by brachytherapy (BRT). During follow-up, 14.5% of these patients experienced persistent or recurrent disease. Clear recommendations for optimal treatment in such cases are currently lacking.

Methodology Patients who applied to Hacettepe University between 2015–2022, underwent cytoreductive surgery for persistent or recurrent disease after primary CRT and BRT were retrospectively analysed.

Results Sixteen patients (median age: 52) received 50.4 Gy external radiotherapy and cisplatin (4–7 cycles). Subsequently, 4x7 Gy BRT was applied to 10 patients (62%), and BRT could not technically be applied to the remaining 6 patients. Eight (50%) underwent surgery for residual tumour(Group-A) post-CRT, and 8 (50%) for recurrence (Group-B) (table 1).

Negative surgical margins were detected in 15 (93.75%) patients. After a median follow-up of 39.4 months (25.8- 51), group-b patients had DFS (Disease Free Survival) and OS (Overall Survival) rates of 37.5% and 50% after 2 years, and 25% and 25% after 5 years. For group-a patients, 2-year DFS and OS rates were 25% and 37.5%, respectively. 5-year rates couldn’t be calculated due to insufficient follow-up. Postoperative DFS and OS were 14.5 and 19 months for the group-a, and 19.5 and 24.5 months for the group-b. One patient had grade 2 toxicity, requiring a blood transfusion after exenteration, while another had grade 3 toxicity, necessitating revision surgery for fistula repair. Two patients had recurrences post-surgery. One underwent exenteration, and the other one received palliation. No patient died due to surgery, but 3/16 (18.87%) died due to disease progression.

Conclusion Surgery is a curative option for residual or recurrent cervical cancer after primary CRT.A multidisciplinary tumor board’s involvement in our center may explain low rates of positive margins and complications. Tailoring treatment for each patient is crucial in such cases.

Disclosures There is no conflict of interest in the study.

Abstract 827 Table 1

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