LOCALLY ADVANCED CERVICAL CANCER : WHOS AT RISK OF RECURRENCE ?

Background: In Morocco, locally advanced cervical cancer (LACC) remains a significant public health concern, with recurrence rates of 15-50% despite standard treatment involving concurrent chemoradiotherapy (CCRT) and uterovaginal brachytherapy (UVBT). Identifying predictors of recurrence is critical for optimizing therapeutic strategies.

Methods: This retrospective cohort study (2018-2022) analyzed 61 LACC patients treated with CCRT at a tertiary center. Data included demographics, tumor characteristics (FIGO 2018 stage, histology, lymph node status), treatment details (UVBT use, treatment duration), and recurrence outcomes. Statistical analyses (SPSS v25.0) comprised descriptive statistics, Kaplan-Meier survival estimates, and univariate analysis (p0.05).

Results: The mean age was 55.3 years 86.9% had squamous cell carcinoma, and 40.9% were FIGO IIIC. Recurrence occurred in 31.1% (60% locoregional). Factors significantly associated with recurrence included anemia (Hb 10 g/dL p=0.021), hydronephrosis (p=0.027), advanced FIGO stage (p0.001), treatment prolongation 55 days (p0.001), and omission of UVBT (p0.001). Recurrence-free survival was 75.2% at 1 year and 71.9% at 2 years.

Conclusion: Pretreatment anemia, hydronephrosis, advanced stage, prolonged treatment, and lack of UVBT were key predictors of recurrence. These findings advocate for personalized risk-adapted protocols and underscore the need for timely, standardized therapy in resource-limited settings.