title: Surgical morbidity and oncologic results after concurrent chemoradiation therapy for advanced cervical cancer.
abstract: OBJECTIVE
  To evaluate the surgical morbidity and oncologic results after concurrent chemoradiotherapy (CCRT) followed by completion surgery for advanced cervical carcinoma.
  
  
  METHODS
  The present retrospective analysis included 192 patients with advanced cervical cancer (stage IIB-IVA) treated with CCRT followed by surgery and 186 control patients without completion surgery. Disease-free and overall survival rates were compared.
  
  
  RESULTS
  Of the patients who underwent surgery, 27 (14.1%) had pathologic evidence of residual disease; the local control rate with CCRT was 85.9%. After a median follow-up period of 190 months, 32 (16.7%) patients who underwent completion surgery had a recurrence compared with 59 (31.7%) of those who did not. The overall survival rate among patients who underwent extrafascial hysterectomy, extended hysterectomy, or no surgery was 72.2%, 60.1%, and 45.9% at 3 years, and 53.5%, 40.7%, and 32.2% at 5 years, respectively.
  
  
  CONCLUSIONS
  Surgery after CCRT for advanced cervical cancer enabled evaluation of the pathologic response to therapy, improved local disease control in patients with a partial pathologic response, and enhanced survival. The most appropriate surgical approach was extrafascial hysterectomy with pelvic lymph node dissection.
authors.affiliation: Department of Gynecologic Oncology, Shandong Cancer Hospital, Shandong Academy of Medical Sciences, Shandong University, Jinan, China.
authors.forename: Li
authors.initials: L
authors.lastname: Sun
authors.affiliation: Department of Gynecologic Oncology, Shandong Cancer Hospital, Shandong Academy of Medical Sciences, Shandong University, Jinan, China. Electronic address: jnshengxg@163.com.
authors.forename: Xiugui
authors.initials: X
authors.lastname: Sheng
authors.affiliation: Department of Gynecology, Jinan Central Hospital Affiliated to Shandong University, Jinan, China.
authors.forename: Jingyan
authors.initials: J
authors.lastname: Jiang
authors.affiliation: Department of Gynecologic Oncology, Shandong Cancer Hospital, Shandong Academy of Medical Sciences, Shandong University, Jinan, China.
authors.forename: Xinglan
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Gynecologic Oncology, Shandong Cancer Hospital, Shandong Academy of Medical Sciences, Shandong University, Jinan, China.
authors.forename: Naifu
authors.initials: N
authors.lastname: Liu
authors.affiliation: Department of Gynecologic Oncology, Shandong Cancer Hospital, Shandong Academy of Medical Sciences, Shandong University, Jinan, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Gynecologic Oncology, Shandong Cancer Hospital, Shandong Academy of Medical Sciences, Shandong University, Jinan, China.
authors.forename: Tingting
authors.initials: T
authors.lastname: Zhang
authors.affiliation: Department of Gynecologic Oncology, Shandong Cancer Hospital, Shandong Academy of Medical Sciences, Shandong University, Jinan, China.
authors.forename: Dapeng
authors.initials: D
authors.lastname: Li
authors.affiliation: Department of Gynecologic Oncology, Shandong Cancer Hospital, Shandong Academy of Medical Sciences, Shandong University, Jinan, China.
authors.forename: Xiaoling
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Department of Gynecologic Oncology, Shandong Cancer Hospital, Shandong Academy of Medical Sciences, Shandong University, Jinan, China.
authors.forename: Ping
authors.initials: P
authors.lastname: Wei
mesh_terms: D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000556:secondary / Q000628:therapy*; D059186:Chemoradiotherapy, Adjuvant; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects / Q000379:methods; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009364:Neoplasm Recurrence, Local / Q000473:pathology* / Q000517:prevention & control; D018365:Neoplasm, Residual; D010388:Pelvis; D012189:Retrospective Studies; D015996:Survival Rate; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000628:therapy*; D055815:Young Adult
keywords: Cervical cancer; Complications; Concurrent chemoradiotherapy; Surgery