Introduction. The goal of this study was to compare the outcomes of preoperative brachytherapy followed by radical surgery versus radical surgery alone in cervical cancer with tumor between 2 and 4 cm (FIGO 2018 IB2).Material and methods. SENTICOL I and SENTICOL II were two French prospective multicentric trials evaluating sentinel node biopsy in early-stage cervical cancer between 2005 and 2012. Preoperative brachytherapy (low -dose rate or pulse-dose rate at the dose of 60Gy) could be performed 6 to 8 weeks prior to the radical hysterec-tomy, at the discretion of each center. SENTICOL I and SENTICOL II cohorts were retrospectively analysed to com-pare the outcomes of preoperative brachytherapy or upfront surgery in patients with IB2 cervical tumor.Results. A total of 104 patients were included: 55 underwent upfront radical hysterectomy and 49 underwent preoperative brachytherapy followed by radical hysterectomy. Patients with preoperative brachytherapy were more likely to have no residual disease (71.4% vs. 25.5%, p < 0.0001) and to be defined as low risk according to Sedlis criteria (83.3% vs. 51.2%, p < 0.0001). Adjuvant treatments were required less frequently in case of preop-erative brachytherapy (14.3% vs. 54.5%, p < 0.0001). Patients with preoperative brachytherapy experienced more postoperative complications grade >= 3 (24.5% vs. 9.1%, p = 0.03). Patients with preoperative brachytherapy had better 5-year disease-free survival compared to patients who underwent surgery alone, 93.6% and 74.4% respectively (p = 0.04).Conclusion. Although preoperative brachytherapy was significantly associated with more severe postopera-tive complications, better pathologic features were obtained on surgical specimens and led to a better 5-year disease-free survival in IB2 cervical cancer.(c) 2023 Elsevier Inc. All rights reserved.

A task force was organized to write French national recommendations for management of ovarian cancer. We proposed to present strengths and weaknesses of this work. (C) 2018 Published by Elsevier Masson SAS.

Objective Sentinel lymph node (SLN) biopsy has been increasingly used in the management of early-stage cervical cancer. It appears in guidelines as an alternative option to systematic pelvic lymphadenectomy. The evidence about safety is, however, based mostly on retrospective studies, in which SLN was combined with systematic lymphadenectomy. Materials and methods SENTIX is a prospective multicenter trial aiming to prove that less-radical surgery with SLN is non-inferior to treatment with systematic pelvic lymphadenectomy. The primary end point is recurrence rate; the secondary end point is the prevalence of lower-leg lymphedema and symptomatic pelvic lymphocele. The reference recurrence rate was set up conservatively at 7% at 24 months after treatment. With a sample size of 300 patients treated per protocol, the trial is powered to detect a non-inferiority margin of 5% (90% power, p = 0.05) for recurrence rate, 30% reduction in the prevalence of symptomatic lymphocele or lower-leg lymphedema, with reference rates of 30% and 6% at 12 months (p = 0.025, Bonferroni correction). The patients eligible for SENTIX have stage IA1/LVSI+, IA2, IB1 (<2 cm for fertility sparing), with negative LN on pre-operative imaging. Intra-operatively, patients are excluded when there is a failure to detect SLN on both sides of the pelvis in cases of more advanced cancer (stage >IB1), or a positive intra-operative SLN assessment. The quality of SLN pathology evaluation will be assessed by central review. Three interim safety analyses are pre-planned when 30, 60, 150 patients complete 12 months' follow-up. Conclusions The first patient was enrolled into the study in June 2016 and, by June 2018, 340 patients had been enrolled. The first analysis of secondary outcomes should be available in 2019 and the oncological outcome of 300 patients at the end of 2021. The trial is registered as a CEEGOG trial (CEEGOG CX-01), ENGOT trial (ENGOT-Cx 2), and at the ClinicalTrials.gov database (NCT02494063).

ESTRO 37 organ sparing radiochemotherapy leading to a high toxicity burden.Head and neck oncologists are therefore actively exploring ways to limit toxicity related to treatment by reducing the number of treatment modalities and/or reducing intensity/dose of a given modality without compromising efficacy in these younger good prognostic patients.Many studies are underway to define deescalation more precisely.Studies use either deintensification of chemotherapy, de-intensification of radiotherapy or de-intensification of surgery/adjuvant therapy.Preliminary results of these studies are encouraging, but longer follow up is warranted.Further research improving our understanding of the underlying biology is needed and until mature results from prospective phase 3 clinical trials are available, deintensification of therapy should not be performed outside a clinical trial.

Objective: The aim of this study was to compare the morbidity of vaginal radical trachelectomy (VRT) and laparoscopic-assisted radical vaginal trachelectomy (LARVT) for early-stage cervical cancer.

Objective: The aim of this study was to compare the morbidity of pelvic lymphadenectomy and the sentinel lymph node (SLN) biopsy during radical trachelectomy for early-stage cervical cancer.

Objective: The aim of this study was to assess the early and late postoperative functional outcomes of patients who have undergone a laparoscopic-assisted radical vaginal trachelectomy (LARVT) for early-stage cervical cancer.

Objective: Sentinel lymph node (SLN) biopsy is now part of management of cervical cancer. This approach was validated through several retrospective and prospective studies. We present the 5-year follow-up of a prospective multicenter study in France (Senticol 1 study).

5529 Background: The aim of this study was to assess the post-operative morbidity of patients who have undergone a radical trachelectomy for early-stage cervical cancer and the oncologic outcomes. Methods: We retrospectively analyzed the data of two prospective trials on sentinel node biopsy for cervical cancer (SENTICOL I & II). Patients underwent a radical trachelectomy for early-stage cervical cancer between January 2005 and March 2012 from 8 French oncologic centers. Results: A total of 61 patients have undergone a radical trachelectomy: 41 patients by laparoscopic-assisted vaginal way, 7 patients by total laparoscopic way, 11 patients by total vaginal way and 2 patients by laparotomy. The median age was 33 years (range = 22-68 years). 88.5 % of patients had a stage IB1 disease. There were 63.9% of epidermoid carcinoma and 34.4 % of adenocarcinoma. Eighteen patients (29.5%) had only a sentinel lymph node biopsy and 43 patients (70.5%) had an additional pelvic lymphadenectomy. The median follow-up was 46 months (range = 0-85 months). Twenty patients (32.8%) had a urinary complication. There were 12 cases of urinary infections (19.6%), 6 cases of dysuria (9.8%), 3 cases of urinary incontinence (4.9%), and one case of ureteral fistula (1.6%). Nine patients had a major neurologic complication (14.7%): the genito-femoral nerve was injured in 4 cases (6.5%) and the obturator nerve was injured in 5 cases (8.2%). Sixteen patients (26.2%) presented a lymphovascular complication. There were 12 cases of limb lymphedema (19.7%) and 5 cases of pelvic lymphocyst (8.2%). During the follow-up, 3 patients (4.9%) had a local recurrence and two patients died : one from a breast cancer and one from a liver metastasis. Conclusions: The radical trachelectomy is a feasible and safe alternative option for young patient with a early-stage cervical cancer in order to preserve their fertility. See table. [Table: see text]

e17007 Background: The aim of this study was to assess the early and late post-operative morbidity of patients who have undergone a radical hysterectomy (RH) for early-stage cervical cancer. Methods: We retrospectively analyzed the data of two prospective trials on sentinel node biopsy for cervical cancer (SENTICOL I & II). Patients underwent a radical hysterectomy for early-stage cervical cancer between January 2005 and March 2012 in 23 French oncologic centers. Results: A total of 412 patients were enrolled and 284 had a radical hysterectomy. Data were complete for 232 patients: 115 by laparoscopic-assisted vaginal way, 80 patients by total laparoscopic way, 9 patients by total vaginal way, 22 patients by laparotomy and 6 patients by robot-assisted way. The median age was 44 years (range = 25-85 years). 89.6 % of patients had a stage IB1 disease. 72.4% were epidermoid carcinoma and 24.6% adenocarcinoma. Eighty-one patients (35%) had only a sentinel lymph node biopsy and 151 patients (65%) had an additional pelvic lymphadenectomy. There were 45 cases of urinary infections (19.4%), 17 cases of dysuria (7.3%), 10 cases of urinary incontinence (4.3%), and 6 cases of ureteral or vesical fistula (2.6%). The genito-femoral nerve was injured in 25 cases (10.7%) and the obturator nerve was injured in 22 cases (9.5%). There were 38 cases of limb lymphedema (16.3%) and 14 cases of pelvic lymphocyst (6%). Conclusions: These complications rates are similar with those found in the current literature. Urinary infections and limb lymphedema are the main complications of RH. The functional outcomes could be improved by applying nerve-sparing techniques. [Table: see text]

Pelvic exenteration remains one of the most mutilating procedures, with important postoperative morbidity, an altered body image, and long-term physical and psychosocial concerns. This study aimed to assess quality of life (QOL) during the first year after pelvic exenteration for gynecologic malignancy performed with curative intent.

The direct relationship between surgical radicality to compensate biologic behavior and improvement of patient outcome at the time of primary or interval cytoreduction remains unclear.