Completion surgery or not after concurrent chemoradiotherapy for locally advanced XXXX ?

@entity1 @entity204 @entity5
OBJECTIVES: The role of additional surgery in @entity1 responding to radiation and chemotherapy for locally advanced @entity5 is controversial. The goal of this study was to compare disease-free survival (DFS) and overall survival (OS) of two groups of @entity1 , with or without additional surgery. STUDY DESIGN: One hundred and eleven @entity1 with advanced @entity5 who responded to chemoradiotherapy followed by brachytherapy were included in a retrospective, multicenter series. RESULTS: Of the @entity1 who had completion surgery (Group 1), 22.4% (15/67) had recurrence compared with 36.4% (16/44) of those who did not have surgery (Group 2). The difference is statistically significant (p=0.01). The relative risk of disease progression or @entity204 was 0.41 (95% confidence interval 0.20-0.85) (p=0.01) in favor of completion surgery. After multivariate analysis, only age, pathology and @entity5 size remained significant (respectively p=0.003, p=0.001 and p=0.03). Among the locations of recurrence in Group 1, 46.7% were pelvic (7/15) compared with 56.2% in Group 2 (9/16). In Group 1, 16.4% (11/67) of the @entity1 died of disease compared to 20.4% (9/44) in Group 2. Of these, 45.4% (5/11) in Group 1 died after pelvic recurrence as compared to 77.8% (7/9) in Group 2. CONCLUSION: Completion surgery does not improve OS but may improve DFS. There is no consensus regarding completion surgery in advanced @entity5 with a good response to the standard treatment but we think it is safer to propose it.
