[Place of surgery before and after concurrent chemoradiotherapy for locally advanced cervical carcinoma: A retrospective study of 102 cases].
BACKGROUND
The treatment of locally advanced cervical carcinoma of uterine cervix is based on concurrent chemoradiotherapy (CCR). The role of laparoscopic lymphadenectomy before CCR and hysterectomy after CCR is not consensual.


METHODS
Retrospective multicentric study on 102 patients treated for locally advanced carcinoma of uterine cervix between 1999 and 2008. Disease-free survival and overall survival (OS) were studied.


RESULTS
Stages were: stage IB 42%, II 47% and stage III and IVA 11%. All patients received CCR. Eighty-one patients had associated brachytherapy. Sixty-two patients underwent laparoscopic lymphadenectomy before CCR and 31 patients had also para-aortic lymphadenectomy. Eighty-two patients had hysterectomy after CCR. Forty-seven percent (29/62) of patients had a histologically proven pelvic lymph node involvement and 58% (18/31) had a histologically proven para-aortic lymph node involvement. There is no predictor of the presence of residual tumor on hysterectomy. The lymph node involvement before treatment and the presence of residual tumor on hysterectomy were poor prognostic factors on relapse-free survival (SSR) and OS. It has not been shown to benefit from surgery pre- or post-CCR on survival.


CONCLUSIONS
Surgery can provide major prognosis factor and especially lymphadenectomy before CCR can improve the therapeutic strategy but does not demonstrate significant survival benefit.
CHU Anne-de-Bretagne, Rennes, France. vincent.lavoue@chu-rennes.fr
V
V
Lavoué
L
L
Voguet
C
C
Bertel
H
H
Mesbah
D
D
Williaume
B
B
Laguerre
P
P
Porée
F
F
Foucher
E
E
Montpetit
M
M
Leblanc
J
J
Levêque
D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D055815:Young Adult