218 Role of completion hysterectomy after concomitant chemoradiation in cervical cancer outcome

Objectives To compare outcomes of patients with cervical cancer treated by chemoradiation (CRT) versus chemoradiation plus completion hysterectomy (CRT+CH). Methods This study compares 44 patients treated by the combination of CRT+CH and 130 patients treated by tradional CRT alone, in a single institution, from 2008 to 2018. We analyzed recurrence rate, local control, overall survival and complication. The FIGO (2009) stage were as follow: 30 IB2, 19 IIA, 125 IIB. There were 137 squamous cell carcinomas and 37 adenocarcinomas. Chemoradiation was the same to both groups: combination of external beam radiotherapy (EBRT) to the pelvis and intracavitary brachytherapy and concomitant platin-based chemotherapy. Completion hysterectomy were performed after 6–14 weeks from the end of chemoradiation. All surgeries were laparoscopic (Piver I) hysterectomy without lymph node dissection. Results Recurrence (local and distant) was higher in the CRT group, although not statistically significant. Mortality was higher in the CRT group (54,6% vs 18,2%, p>0.05). Complications was similar in both groups (10% vs 9,1%). No differences regarding KPS or FIGO stage were identified among groups. Conclusions CRT+CH seems to improve survival, without adding morbidity for patients with FIGO stages 1B2, IIA and IIB cervical cancer. It also seems that adenocarcinoma treated by CRT+CH had better results concerning relapses and mortality, compared to the CRT group.