Citation Information :
Shanmugam S, Balakrishnan S. Retrospective Analysis on the Need for Surgery for Residual Disease after Chemoradiation in Carcinoma Cervix. J South Asian Feder Obs Gynae 2023; 15 (4):382-384.
Introduction: Concurrent chemoradiation is the treatment of choice for patients from stage IB3–IVA disease. We analyzed patients with carcinoma cervix who underwent definitive chemoradiation, and had residual disease either clinically or radiologically during the period from July 2021 to August 2022. In the past 1 year, we treated 11 patients with definitive chemoradiation residue. We did radical surgery for those patients.
Results: Out of the 11 patients who had residual disease after definitive chemoradiation, 4 patients had clinical residual disease and 7 patients on imaging. Postoperative histopathological examination (HPE) showed 4 out of 10 patients were without any disease and all those patients were diagnosed by imaging. Out of 11 patients, 1 had an intraoperative ureteric injury, 2 patients had postoperative ureteric/vesicovaginal fistula, 1 patient had intraoperative bleeding, 1 patient had intraoperative bowel injury and there was 1 death. Three patients had minor complications.
Conclusion: Even though our numbers are less, we found out that there is a possibility of misinterpretation of postradiation changes as a residual disease by magnetic resonance imaging (MRI) and while operating for these patients, we should anticipate more complications and chances of no residual disease. We suggest a strong clinical correlation along with histopathological confirmation before surgical intervention, which may avoid unwanted radical surgery for such patients. At the same time, we cannot neglect the possibility of a real risk of residual disease (6/10 had residual disease) progressing further leading to a missed opportunity for a cure.
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