PURPOSE: Concomitant chemoradiation followed by brachytherapy is the standard treatment for locally advanced @entity5 . The place of @entity1753 remains unclear but tends to be limited to incomplete responses to radiotherapy or local relapse. The aim was to analyse the benefit from immediate salvage surgery following radiation therapy in incomplete responders. METHODS: Among the @entity1 with locally advanced @entity5 treated with concomitant chemoradiation followed by 3D image-guided adaptive brachytherapy and hysterectomy, cases with genuine macroscopic remnant, defined as at least 1cm in width, were identified. Their clinical data and outcomes were retrospectively reviewed and compared to the @entity1 treated with the same modalities. RESULTS: Fifty-eight @entity1 were included, with a median follow-up of 4.2 years. After hysterectomy, 9 @entity1 had macroscopic residual disease, 10 microscopic and the remaining 39 @entity1 were considered in complete histological response. The 4-year overall survival and disease-free survival rates were significantly decreased in @entity1 with macroscopic residual disease: 50 and 51% versus 92% and 93%, respectively. Intestinal grades 3-4 @entity137 were reported in 10.4% and urinary grades 3-4 in 8.6% in the whole population without distinctive histological features. Planning aims were reached in only one @entity1 with macroscopic residuum (11.1%). In univariate analysis, overall treatment time (>55 days) and histological subtype ( @entity420 or @entity1962 ) appeared to be significant predictive factors for macroscopic remnant after treatment completion (P=0.021 and P=0.017, respectively). In multivariate analysis, treatment time was the only independent factor (P=0.046, odds ratio=7.0). CONCLUSIONS: Although immediate salvage hysterectomy in incomplete responders provided a 4-year disease-free survival of 51%, its impact on late morbidity is significant. Efforts should focus on respect of treatment time and dose escalation. @entity420 might require higher high-risk clinical target volume planning aims.

What to expect from immediate salvage hysterectomy following concomitant chemoradiation and image-guided adaptive brachytherapy in locally advanced XXXX .

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity137 :: ('MESH:D064420', 'Disease') :: ['toxicities'] @entity5 :: ('MESH:D009369', 'Disease') :: ['cervical cancer', 'cervical cancers'] @entity1753 :: ('MESH:D001169', 'Disease') :: ['adjuvant hysterectomy'] @entity1962 :: ('MESH:D018196', 'Disease') :: ['adenosquamous carcinomas'] @entity420 :: ('MESH:D000230', 'Disease') :: ['adenocarcinomas', 'Adenocarcinoma']
@entity5 :: (MESH:D009369,Disease) :: ['cervical cancer']
