title: Disease courses in patients with residual tumor following concurrent chemoradiotherapy for locally advanced cervical cancer.
abstract: OBJECTIVE
  To investigate the disease course and identify prognostic factors for survival in patients with residual disease according to post-treatment magnetic resonance imaging (MRI) following definitive concurrent chemoradiotherapy (CCRT) for locally advanced cervical cancer.
  
  
  METHODS
  We reviewed clinical data from the medical records of 545 consecutive women with biopsy-proven, International Federation of Gynecology and Obstetrics stage IB2-IVA uterine cervical cancer treated with CCRT. Post-treatment MRI was checked in all patients 3months after CCRT completion. Out of the 545 patients, 53 with residual cervical cancer based on MRI following definitive CCRT were included in this analysis.
  
  
  RESULTS
  Thirty-two patients were disease-free at the last follow-up. Of them, 31 had a residual tumor size of ≤2cm. Of these 32 women, 30 showed spontaneous regression of residual tumor during follow-up without salvage treatments, whereas the remaining two were alive with no evidence of disease after salvage surgery and chemotherapy. Disease progression was observed in 21 patients, including 7 local, 8 distant and 6 local and distant failures. Of these 21 women, 13 died of disease, 6 were alive with disease, and 2 remained disease-free after salvage treatments. Initial and residual tumor sizes were significant prognostic factors for overall survival; only residual tumor size was significant for local progression-free survival.
  
  
  CONCLUSIONS
  About 60% of patients with residual disease detected on post-treatment MRI remained disease-free without further disease progression. Careful observation without immediate salvage treatments might be feasible in selected patients with a residual tumor size ≤2cm.
authors: Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
authors: Ja Young
authors: JY
authors: Kim
authors: Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
authors: Sang Jun
authors: SJ
authors: Byun
authors: Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. Electronic address: ysk@amc.seoul.kr.
authors: Young Seok
authors: YS
authors: Kim
authors: Department of Obstetrics and Gynecology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
authors: Joo-Hyun
authors: JH
authors: Nam
mesh_terms: D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000000981:diagnostic imaging / Q000556:secondary* / Q000628:therapy*; D059248:Chemoradiotherapy; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009365:Neoplasm Regression, Spontaneous; D009367:Neoplasm Staging; D018365:Neoplasm, Residual; D016879:Salvage Therapy; D015996:Survival Rate; D047368:Tumor Burden; D002583:Uterine Cervical Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy*
keywords: Chemoradiotherapy; Magnetic resonance imaging; Residual disease; Uterine cervical neoplasm