Introduction/Background In FIGO stages IIB-IIIC cervical cancer patients, exclusive chemo-radiotherapy (CCRT) is the gold standard treatment. However, preoperative assessment can be complex in some cases, particularly when parametrial or lymph node involvement is uncertain. In young patients who decline radiotherapy (RT) due to uncertain parametrial or lymph node involvement, neoadjuvant chemotherapy (NACT) could be an option to avoid RT and its side effects. The primary aim of this study was to evaluate the role of dose-dense NACT followed by radical surgery in a selected group of patients with suspected FIGO stage IIB-IIIC who desire an alternative option to RT.

Methodology Patients with suspected FIGO 2018 stages IIB-IIIC at preoperative evaluation including clinical examination and imaging who underwent dose-dense NACT at the European Institute of Oncology, Milan from 11/2014 to 12/2021 were retrospectively identified. None of the patient had unequivocal positive lymph node or parametrial invasion. They received weekly dose-dense carboplatin AUC2 + paclitaxel 80 mg/m2 or carboplatin AUC2.7 + paclitaxel 60 mg/m2 for 5–9 cycles followed by radical hysterectomy plus pelvic lymphadenectomy or CCRT, depending on radiologic response. Response to NACT and follow-up data were evaluated with appropriate statistical analysis.

Results A total of 22 patients meeting inclusion criteria were included (table 1). After dose-dense NACT, 8(36%) patients were deemed inoperable and received CCRT. Among the remaining 14(64%) patients who underwent surgery, 5(36%) received adjuvant CCRT, 1(7%) received chemotherapy alone and the remaining 8(57%) were observed (figure 1). Overall, NACT followed by surgery allowed us to avoid radiotherapy in 8(36%) of the total patients. Among these, during a median follow-up time of 52 months (range 6–94), only 1(13%) patients experienced a recurrence.

Conclusion Although dose-dense NACT followed by surgery is not the standard of care for stage IIB-IIIC cervical cancer, this approach could be considered in selected patients desiring alternative options to RT.

Disclosures The Author have no conflicts of interest to declare.

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Abstract 1104 Figure 1

Abbreviation: NACT, Neo-adjuvant chemotherapy, CCRT, Chemoradiotherapy, PLND, Pelvic lymphadenectomy, CR, complete response, PR, partial response, SD, stable disease, PD, progressive disease