Journal
ANTICANCER RESEARCH
Volume 39, Issue 6, Pages 2919-2926Publisher
INT INST ANTICANCER RESEARCH
DOI: 10.21873/anticanres.13421
Keywords
Locally advanced cervical cancer; chemoradiation therapy; brachytherapy salvage hysterectomy; morbidity
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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.
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