Li Sun1, Xiugui Sheng2, Jingyan Jiang3, Xinglan Li1, Naifu Liu1, Yi Liu1, Tingting Zhang1, Dapeng Li1, Xiaoling Zhang1, Ping Wei1. 1. Department of Gynecologic Oncology, Shandong Cancer Hospital, Shandong Academy of Medical Sciences, Shandong University, Jinan, China. 2. Department of Gynecologic Oncology, Shandong Cancer Hospital, Shandong Academy of Medical Sciences, Shandong University, Jinan, China. Electronic address: jnshengxg@163.com. 3. Department of Gynecology, Jinan Central Hospital Affiliated to Shandong University, Jinan, China.
Abstract
OBJECTIVE: To evaluate the surgical morbidity and oncologic results after concurrent chemoradiotherapy (CCRT) followed by completion surgery for advanced cervical carcinoma. METHODS: The present retrospective analysis included 192 patients with advanced cervical cancer (stage IIB-IVA) treated with CCRT followed by surgery and 186 control patients without completion surgery. Disease-free and overall survival rates were compared. RESULTS: Of the patients who underwent surgery, 27 (14.1%) had pathologic evidence of residual disease; the local control rate with CCRT was 85.9%. After a median follow-up period of 190 months, 32 (16.7%) patients who underwent completion surgery had a recurrence compared with 59 (31.7%) of those who did not. The overall survival rate among patients who underwent extrafascial hysterectomy, extended hysterectomy, or no surgery was 72.2%, 60.1%, and 45.9% at 3 years, and 53.5%, 40.7%, and 32.2% at 5 years, respectively. CONCLUSION: Surgery after CCRT for advanced cervical cancer enabled evaluation of the pathologic response to therapy, improved local disease control in patients with a partial pathologic response, and enhanced survival. The most appropriate surgical approach was extrafascial hysterectomy with pelvic lymph node dissection.
OBJECTIVE: To evaluate the surgical morbidity and oncologic results after concurrent chemoradiotherapy (CCRT) followed by completion surgery for advanced cervical carcinoma. METHODS: The present retrospective analysis included 192 patients with advanced cervical cancer (stage IIB-IVA) treated with CCRT followed by surgery and 186 control patients without completion surgery. Disease-free and overall survival rates were compared. RESULTS: Of the patients who underwent surgery, 27 (14.1%) had pathologic evidence of residual disease; the local control rate with CCRT was 85.9%. After a median follow-up period of 190 months, 32 (16.7%) patients who underwent completion surgery had a recurrence compared with 59 (31.7%) of those who did not. The overall survival rate among patients who underwent extrafascial hysterectomy, extended hysterectomy, or no surgery was 72.2%, 60.1%, and 45.9% at 3 years, and 53.5%, 40.7%, and 32.2% at 5 years, respectively. CONCLUSION: Surgery after CCRT for advanced cervical cancer enabled evaluation of the pathologic response to therapy, improved local disease control in patients with a partial pathologic response, and enhanced survival. The most appropriate surgical approach was extrafascial hysterectomy with pelvic lymph node dissection.