Would you give additional radiation for a positive margin after salvage hysterectomy for a patient with cervical cancer who had initial definitive chemoradiation with EBRT+T&R?

Would you consider additional EBRT or vaginal cuff HDR in a patient with previous tx with EBRT (45Gy) + HDR (30Gy) for a R1 resection with a radial margin (+) at the vaginal cuff and parametria? Would a Mesonephric Adenocarcinoma histology affect your recommendations?

2 Answers

Mednet MemberInvited Expert

Radiation Oncology · Varian Medical Systems/Allegheny health network

Answered on

I would favor repeat surgery if that is an option as otherwise salvage rate very low.

If it can't be done, then assess for interstitial brachy.

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Mednet Member

Radiation Oncology · New York Cancer and Blood Specialists

Answered on

Patients usually have radical hysterectomy, so repeating surgery is not an option for most cases. I may recommend vaginal cuff brachytherapy in this case.

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