title: The role of completion surgery after concurrent radiochemotherapy in locally advanced stages IB2-IIB cervical cancer.
abstract: BACKGROUND
  The gold standard for treating patients with locally advanced stages of cervical cancer is concurrent radiochemotherapy (CRT), but recent studies have failed to demonstrate the effect of completion surgery on survival. The aim of this study was to evaluate the role of completion surgery in stage IB2-IIB cervical cancer.
  
  
  METHODS
  From 2002 to 2012, 80 women (stage IB2-IIB disease) underwent a pre-therapeutic pelvic and para-aortic lymphadenectomy associated with CRT.
  
  
  RESULTS
  Forty-six patients (57.5%) underwent completion surgery. Multivariate analysis identified pelvic lymph node status as a predictive factor for completion surgery (p<0.001) and histological type for tumor residue (p=0.04). In multivariate analysis, positivity of para-aortic nodes (p=0.01 for DFS and p=0.01 for OS) and emboli on completion hysterectomy (p=0.03 for DFS and p=0.006 for OS) were significant.
  
  
  CONCLUSIONS
  Only patients without para-aortic metastases or limited pelvic involvement and with residual disease and emboli seem to be good candidates for completion surgery.
authors.affiliation: Department of Gynecology-Obstetrics, Hôpital Tenon, Paris, France. elisabeth.chereau@gmail.com
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Chereau
authors.forename: Claire
authors.initials: C
authors.lastname: DE LA Hosseraye
authors.forename: Marcos
authors.initials: M
authors.lastname: Ballester
authors.forename: Laurie
authors.initials: L
authors.lastname: Monnier
authors.forename: Roman
authors.initials: R
authors.lastname: Rouzier
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Touboul
authors.forename: Emile
authors.initials: E
authors.lastname: Daraï
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D059248:Chemoradiotherapy / Q000401:mortality*; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008197:Lymph Node Excision / Q000401:mortality*; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009367:Neoplasm Staging; D018365:Neoplasm, Residual / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D002583:Uterine Cervical Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*