Marie Gosset1, Cyrus Chargari2,3, Erica Bentivegna4, Alexandra Leary5, Catherine Genestie6, Amandine Maulard4, Philippe Morice4,3, Sebastien Gouy4. 1. Department of Surgery, Gustave Roussy, Villejuif Cedex, France marie.gosset@outlook.com. 2. Department of Radiotherapy, Gustave Roussy, Villejuif Cedex, France. 3. Paris Sud University, Kremlin Bicêtre, France. 4. Department of Surgery, Gustave Roussy, Villejuif Cedex, France. 5. Department of Oncology, Gustave Roussy, Villejuif Cedex, France. 6. Department of Biology and Pathology, Gustave Roussy, Villejuif Cedex, France.
Abstract
BACKGROUND/AIM: We evaluated patients undergoing salvage hysterectomy after brachytherapy (BT) following concomitant chemoradiation (CRT) for locally advanced cervical cancers (LACC), when residual disease was suspected. PATIENTS AND METHODS: From 2004 to 2013, 29 patients had a radical hysterectomy at the Gustave Roussy for suspicion of clinical and/or radiological residual disease. Outcomes, morbidities and the accuracy of the evaluation of response to CRT and BT were evaluated. RESULTS: The rate of complications grade>IIIa was 24%, with no difference between the 14 patients with histological residual disease and the 15 with a complete response. Magnetic resonance imaging (MRI) and positron emission tomography-computed tomography (PET-CT) revealed a sensitivity of 92% and 100%, but a poor specificity of less than 40%. Three recurrences occurred in patients with residual disease (brain, rectosigmoid colon, peritoneum and lung). CONCLUSION: The clinical examination, MRI and PET-CT are suboptimal for diagnosing residual disease after CRT and BT. The morbidity of adjuvant hysterectomy is high and does not prevent recurrences. Copyright
BACKGROUND/AIM: We evaluated patients undergoing salvage hysterectomy after brachytherapy (BT) following concomitant chemoradiation (CRT) for locally advanced cervical cancers (LACC), when residual disease was suspected. PATIENTS AND METHODS: From 2004 to 2013, 29 patients had a radical hysterectomy at the Gustave Roussy for suspicion of clinical and/or radiological residual disease. Outcomes, morbidities and the accuracy of the evaluation of response to CRT and BT were evaluated. RESULTS: The rate of complications grade>IIIa was 24%, with no difference between the 14 patients with histological residual disease and the 15 with a complete response. Magnetic resonance imaging (MRI) and positron emission tomography-computed tomography (PET-CT) revealed a sensitivity of 92% and 100%, but a poor specificity of less than 40%. Three recurrences occurred in patients with residual disease (brain, rectosigmoid colon, peritoneum and lung). CONCLUSION: The clinical examination, MRI and PET-CT are suboptimal for diagnosing residual disease after CRT and BT. The morbidity of adjuvant hysterectomy is high and does not prevent recurrences. Copyright
Authors: Dong Hyung Lee; Jong Kil Joo; Dong Soo Suh; Byung Sup Shin; Seo Yoon Hwang; Ki Hyung Kim Journal: Medicine (Baltimore) Date: 2022-01-21 Impact factor: 1.889