Should We Cease to Perform Salvage Hysterectomy After Chemoradiation and Brachytherapy in Locally Advanced Cervical Cancer?

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.

journal_name

Anticancer Res

journal_title

Anticancer research

authors

Gosset M,Chargari C,Bentivegna E,Leary A,Genestie C,Maulard A,Morice P,Gouy S

doi

10.21873/anticanres.13421

subject

Has Abstract

pub_date

2019-06-01 00:00:00

pages

2919-2926

issue

6

eissn

0250-7005

issn

1791-7530

pii

39/6/2919

journal_volume

39

pub_type

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