Intention to treat and treatment performed
Whereas 38 patients were scheduled for VRT with SNP and PLND, the
procedure was actually performed in 35 patients. VRT was abandoned in 3
patients due to LN metastases upon serial sectioning after separate
SNP/PNLD procedures. Patients were then treated with chemoradiotherapy.
Following VRT, 1 patient required a complementary hysterectomy due to
positive resection margins upon final pathology, leaving 34 patients who
were successfully and only treated with VRT. One patient with tumor size
>2cm was treated with neoadjuvant chemotherapy and
subsequent VRT in an individualized setting after shared decision
making.
A total of 17 patients were scheduled for radical hysterectomy with SNP
and PLND, and one had a complementary hysterectomy after VRT as
aforementioned. RH was abandoned intraoperatively in 4 patients due to
LN metastases upon frozen section analysis of the sentinel node.
Patients were then treated with chemoradiotherapy. RH was completed in
14 patients, of whom 5 patients required adjuvant (chemo)radiotherapy.
Adjuvant radiotherapy was indicated for 3 patients due to positive
resection margins (n=1) or parametrical involvement (n=2), whereas
adjuvant chemoradiotherapy was performed in 2 patients with LN
metastases upon final pathology.
Chemoradiotherapy was primarily indicated in 20 patients and
additionally indicated in 9 patients upon pathologic risk factors as
mentioned before. As adjuvant radiotherapy was indicated upon final
pathology in another 3 patients, a total of 32 (42.7%) patients were
treated with (chemo)radiotherapy.