Locally advanced cervical cancer: salvage surgery is feasible in some patients

  • Mignot F & al.
  • Gynecol Oncol
  • 13.03.2020

  • von Deepa Koli
  • Studien – kurz & knapp
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Takeaway

  • Salvage surgery is feasible and improves OS without significant complication in highly selected patients with locally advanced cervical cancer local relapse after image-guided adaptive brachytherapy.

Why this matters

  • Local failure causes severe local symptoms.

Study design

  • 259 patients with locally advanced cervical cancer treated with up-front chemoradiation.
  • Funding: None disclosed.

Key results

  • Median follow-up was 4.2 months.
  • 10.8% of patients experienced a local relapse.   
  • Median time to local relapse after the completion of brachytherapy was 8 months.
  • Only 3 (10.7%) of 28 patients with isolated local relapse received salvage surgery.
    • Distant metastases (60.7%) occurrence and pelvic wall involvement (17.9%) were the main contraindications for salvage surgery.
  • After local relapse, 3 patients were alive at last follow-up.
    • Patients who had hysterectomy for isolated local relapse had better survival than those who did not (P=.02).
  • Local progression led to serious loco-regional symptoms; the most common were nephrologic symptoms (42.9%) and sepsis (39.3%).
  • The time interval between brachytherapy and local relapse was a significant risk factor for worse OS at 2 years (HR, 3.3; P=.005).

Limitations

  • Retrospective study.