The Efficacy Of Surgical Treatment After Radiotherapy For Locally Recurrent Or Persistent Cervical Cancer

Objective: To evaluate the safety and efficacy of surgical treatment after radiotherapy for locally recurrent or persistent cervical cancer.Method: The medical records of patients with locally recurrent or persistent cervical cancer after radiotherapy from April 2015 to June 2019 in our department of gynaecology were collected.The patients were divided into surgical and non-surgical group(chemotherapy or chemoradiotherapy)according to the treatment methods.The intraoperative conditions,operative complications and surgical outcomes of the surgical group were analyzed,and the clinical characteristics and survival rates of the two groups were compared.Results: A total of 31 patients were included in the study,11 in the surgical group and 20 in the non-surgical group,all of them had previously received radiotherapy.In the surgical group,no adverse events or treatment-related death occurred during the surgery,and 2(18.2%)patients presented serious postoperative complications.After a median follow-up of28 months,4(36.4%)patients developed recurrent disease,mainly distantmetastasis,and 3(27.3%)patients died from disease progression,with an average progression-free survival(PFS)of 26.3 months and an average overall survival(OS)of 28.8 months.The estimated 3-year progression-free survival and overall survival rates were 54.5% and 56.8%.In the non-surgical group,disease progression was observed in 14(70%)patients after a median follow-up of 8 months,and 10(50%)patients died,the average overall survival was 9.3 months.Comparing the overall survival curve of the two groups found that the OS was prolonged and the OS rate was improved in the surgery group(P < 0.05),with statistical significance.Conclusion: Surgical treatment may bring a better prognosis for patients who developed locally recurrent or persistent cervical cancer after radiotherapy.However,considering the high rate of surgical complications,the patient's condition should be fully evaluated before surgery and surgical indications should be strictly grasped.