Abstract

Introduction: Cervical cancer is a common cancer that affects women worldwide. In India, it is the second most common cancer. Definitive chemoradiation is the standard treatment for locally advanced cervical cancer. However, 30-45% of patients will experience residual or local recurrence after treatment. Aim: This study evaluated the efficacy of type 1 hysterectomy in patients with suspicious residual or recurrent disease on follow-up speculum examination or MRI after definitive chemoradiation for cervical cancer IIIb. Method: A retrospective analysis of 18 patients who underwent type 1 hysterectomy at Royapettah government hospital from 2011 to 2022 was conducted. The patients’ medical records, clinicopathological factors, complications, and prognosis were retrospectively reviewed. Result: Results of the 18 patients included in the study, 3 (16.7%) were found to have residual disease on histopathological examination of the surgical specimens. The 5-year overall survival (OS) and disease-free survival (DFS) rates were 61.1% and 55.5%, respectively. Eight patients had recurrence after type 1 hysterectomy, with a median time to recurrence of 12 months. Of these 8 patients, 3 had recurrence within 6 months. Among these 3 patients, 2 had residue/recurrence in the histopathological examination as adenocarcinoma. Conclusion: Type 1 adjuvant hysterectomy for clinically or radiologically suspicious residue without biopsy proof after definitive chemoradiation in cervical cancer IIIb did not offer survival advantage. Such patients should be kept in strict follow-up with regular speculum examination and MRI. Adjuvant radical hysterectomy/exenteration is a useful option in biopsy-proven recurrence.