Surgery followed by concurrent radiochemotherapy as treatment for patients with locally recurrent cervical cancer

Abstract Background: Salvage radiotherapy modes for treating patients with local cervical cancer recurrence after radical surgery are controversial. Therefore, we aimed to evaluate the clinical efficacy and prognostic significance of two radiotherapy modes—involved-field radiotherapy combined with regional lymph nodes (regional radiotherapy) and involved-field radiotherapy alone (local radiotherapy)—in these patients.Methods: We retrospectively enrolled patients with local recurrence who underwent radical surgery without radiotherapy for early-stage cervical cancer from January 2010 to January 2020. Clinical outcomes were analyzed using the Kaplan–Meier method and a Cox proportional hazards model.Results: Forty-four patients underwent intensity-modulated radiotherapy (IMRT)-based salvage treatment. The 5-year overall survival and progression-free survival rates were 64% and 60.2%, respectively. Sixteen of 18 patients with stump recurrence and 15 of 26 patients with pelvic and abdominal cavity recurrence received regional radiotherapy, while others received local radiotherapy. Univariate analysis showed that patients with stump recurrence, who underwent regional radiotherapy, and with a lower systemic inflammation response index (SIRI) had better prognosis than their counterparts. Patients aged < 51 years, with stump recurrence, recurrence time ≤ 24 months, recurrence site=1, and a lower SIRI who received regional radiotherapy had a better prognosis than patients who received local radiotherapy. SIRI correlated with the recurrence site and radiotherapy mode.Conclusion: Locally recurrent cervical cancer treated with IMRT-based salvage therapy has a good prognosis. Recurrence site, SIRI, and the radiotherapy mode significantly influenced prognosis. Regional radiotherapy may be suitable for patients with stump recurrence, recurrence time ≤ 24 months, and one recurrence site.

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Faculty of 1000 evaluation for Survival data from a phase II, open-label study of pazopanib or lapatinib monotherapy in patients with advanced and recurrent cervical cancer.

F1000 - Post-publication peer review of the biomedical literature ◽

10.3410/f.717998895.793474496 ◽

2013 ◽

Author(s):

David Kushner

Keyword(s):

Cervical Cancer ◽

Phase Ii ◽

Survival Data ◽

Open Label ◽

Recurrent Cervical Cancer ◽

Open Label Study ◽

Label Study

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SURGERY FOR RESIDUAL DISEASE AFTER RADIOTHERAPY IN LOCALLY ADVANCED CERVICAL CANCER

Problems in oncology ◽

10.37469/0507-3758-2019-65-5-721-725 ◽

2019 ◽

Vol 65 (5) ◽

pp. 721-725

Author(s):

Elmira Shakirova ◽

Andrey Panov ◽

Alevtina Akhmetzyanova ◽

Aliya Gafiullina ◽

L. Ibragimova ◽

...

Keyword(s):

Cervical Cancer ◽

Residual Disease ◽

Locally Advanced ◽

Residual Tumor ◽

Advanced Cervical Cancer ◽

Mri Imaging ◽

Recurrent Cervical Cancer ◽

Locally Advanced Cervical Cancer ◽

Visible Effect ◽

Adjuvant Hysterectomy

Aims: Chemoradiation (CRT) is the standard treatment for locally advanced cervical cancer (LACC). However part of the patients develop recurrence during the first year after treatment despite good visible effect at the first follow-up. The role of completion surgery after radiotherapy (RT) is still debated. A number of papers have showed that up to 60% of patients have residual tumor after CRT and RT. But such a surgery is not widely recommended because of increased morbidity of the treatment. The aim of this study was to assess the results of surgery after radiotherapy of LACC. Method: We retrospectively evaluated data on 86 patients with cervical cancer IB - IIIB stages (mostly stage IIB) who underwent surgery in different modalities after CRT and RT with good clinical response in our department in 2015-2018. Results: When small asymptomatic residual disease was detected early after radiotherapy radical hysterectomy was feasible in most of the cases. Patients with clinical manifestation of recurrence had very poor prognosis. Surgery of recurrent cervical cancer sufficiently deteriorates quality of life, even if possible. Conclusion: Thorough examination with adding MRI imaging after initial treatment of cervical cancer needed to identify patients who may benefit from adjuvant hysterectomy.

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