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