Introduction/Background Clear-cell cervical carcinoma (CCCC) is a rare tumour historically associated with in-utero exposure to diethylstilboestrol (DES), accounting about 4% of all adenocarcinomas of the cervix. Little is known about this HPV-independent tumour, and there aren’t clear recommendations concerning its management.

The aim of this study is to assess the survival outcomes and to highlight the evolution of its treatment in the lasts 20 years.

Methodology We collect all the patients with a diagnosis of CCCC treated at the Institut Gustave Roussy of Paris, between 2001 and 2023.

Results A total of 30 patients with a median age of 30 years (14–79), and a 10% of exposure to DES, were included in the study. The 60% of our patients were in advanced International Federation of Gynaecology and Obstetrics (FIGO) stage, with a 16.7% of them presenting a metastatic disease at diagnosis. Surgery alone was performed in 3/30 patients, exclusive chemoradiation followed by brachytherapy was performed in the 30% of cases, and a combination of treatments has been applied in the 46.7% (n=14) of patients. Lymph node sampling was performed in 60% of cases, with an involvement of 11.1%. The median follow-up period was 46 months. The major prognostic factor for adverse outcomes was the extension of the disease, with a 66.7% of demises occurring in advanced FIGO stages.

Conclusion The correct management of CCCC is still an open question. Our data suggest that patients with low risk early stage CCCC may be managed with radical surgery alone. Combination of treatment could be an option in a targeted population, with a significant amount of toxicity.

Disclosures We have no potential conflict of interest to report.