The role of surgery after chemoradiation therapy and brachytherapy for stage IB2/II cervical cancer

Objective. The aim of this study was to review the results of completion surgery after chemoradiation therapy in stage IB2/II cervical carcinoma. Methods. Analysis of series published in the literature about completion surgery in this context. Results. Stages of the disease included in those series were stage IB2-IVA disease. The rate of residual disease was correlated with initial stage of the disease and the use of preoperative brachytherapy. Morbidity of such management varied between 15% and 47% and was correlated with the radicality of the surgical procedure and the size of the residual disease. The rate of complete pathological response varied between 52% and 76%. The survival of patients was correlated with the presence and the size of the residual disease and the presence of a nodal involvement. Conclusion. Completion surgery after chemoradiation therapy has a place in the multimodality management of stage IB2 or II cervical cancer, particularly in cases of bulky residual disease. Nevertheless further investigations are needed, particularly with collaborative studies, to analyze the real impact of such surgery on the survival of patients. (C) 2007 Elsevier Inc. All rights reserved.