Authors:

Alfonso Torres Lobatón^1*, Monica Alejandra Matta Martínez², Rosalva Barra Martínez³, Carla América Suárez Juárez⁴, Maria Yicel Bautista Hernández⁵, Fred Morgan Ortiz⁶ and Juan Carlos Oliva Posada⁷

Surgical Oncologist, Oncology Unit, General Hospital Of Mexico, “Md Eduardo Liceaga”, Mexico.

Abstract:

1.1. Objective: To show the results of complementary and rescue surgeries in patients with Locally Advanced Cervical Cancer (LACC), Squamous Cell Carcinoma (SCC) and Adenocar-Cinoma (ADC), with confirmation or suspicion of tumor persistence to treatment with Chemo-Radio Therapy (CRT) with or without Intra-Cavitary Brachy Therapy (ICBT).

1.2. Material and Methods: Retrospective study of patients treated in the Oncology Service of the General Hospital of Mexico (GHM) in the period from 2008 to 2015, who had a diagnosis of Persistent Cervical Cancer (PCC) and were laparotomized in order to perform complementary or rescue surgeries.

1.3. Results: We performed 100 surgeries, 61 Complementary Hysterectomies (CH) with or without lymphadenectomy, 24 Pelvic Exenterations (PE) and 15 laparotomies because the neoplasm was unresectable. Major Complications (MC) occurred in 11/65 (16.9%) patients treated with CRT and ICBT, and 1/20 (5.0%) of patients in the CRT group without ICBT (p = 0.2290). There was no postoperative mortality. Disease Free Survival (DFS) was 30.5 months in 66/90 (73.3%) of all patients; by surgery 51/56 (91.0%) CH and 15/19 (78.9%) PE; by histopatology, 35/56 (62.5%) with SCC and 31/34 (91.1%) with ADC (p = 0.003); and for stage II the main clinical stage with 58 patients: 22/36 (61.1%) for SCC and 20/22 (90.9%) for ADC (p = 0.0145).

1.4. Conclusions: Adyuvant surgery has a place in the management of LACC with tumor persistence or suspicion of this after conventional treatment with CRT. External Beam Radiation Therapy (EBRT) plus Chemo-Therapy (QT) plus surgery can be considered for the treatment of ADC from CS IB3.

Keywords:

Surgery Persistent; Cervical Cancer; Chemo-radio Therapy; Adenocarcinomas

Citation:

Alfonso Torres Lobatón. Role of Surgery in the treatment of Cervical Cancer Persistent to Chemoradiotherapy and its Importance in the Management of Adenocarcinomas: Experience with 100 Patients. World Journal of Medical Oncology 2020.