Cervical biopsy after chemoradiation for locally advanced cervical cancer to identify residual disease: a retrospective cohort study

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Author Info

Yvonne Marije Hoeijmakers A. Snyers M.A.P.C. v. Ham P.L.M. Zusterzeel R.L.M. Bekkers

Corresponding Author

Yvonne Marije Hoeijmakers
Department of Obstetrics and Gynecology, Radboud University Nijmegen Medical Center, the Netherlands

A B S T R A C T

Objective To evaluate the value of cervical biopsies 12 to 16 weeks post chemoradiation (CRT) in patients with locally advanced cervical cancer (LACC), to identify patients eligible for salvage surgery. Methods We retrospectively collected data of 154 patients with LACC, who received chemoradiation as primary treatment between 1998 and 2015 at the Radboud university medical center in Nijmegen (Radboud). In patients eligible for salvage surgery, without suspicious lymph nodes on imaging, a cervical biopsy was taken post CRT under general anesthesia to evaluate whether complete clinical remission was obtained. We analyzed data from 78 patients with cervical biopsy post CRT and 60 patients without cervical biopsy. Follow-up, biopsy results, patient characteristics and subsequent treatment modalities were reviewed. Results In total, 154 patients with LACC received CRT. The median follow up time was 30.5 months. Sixteen patients (10.4%) were lost to follow up. Of the remaining 138 women, 78 patients underwent a cervical biopsy post CRT. Eight out of the 78 patients (10.3%) had residual disease after CRT, six of these patients underwent salvage surgery, with long-term complete remission in 4 of these patients (66.7%). Conclusion Post CRT cervical biopsy in locally advanced cervical cancer patients was beneficial in 4 out of 78 patients (5%). As 1 in 20 patients will achieve long-term survival by salvage hysterectomy, taking a cervical biopsy 16 weeks post radiation seems thus advisable.

Article Info

Article Type

Research Article

Publication history

Received: Thu 20, Dec 2018
Accepted: Mon 21, Jan 2019
Published: Fri 22, Mar 2019

Copyright

© 2023 Yvonne Marije Hoeijmakers. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Hosting by Science Repository.
DOI: 10.31487/j.JSO.2019.01.001