#529 Outcomes of Patients with Locally Advanced Cervical Cancer (LACC) Without Nodal Involvement

Introduction/Background Cervical tumor size ≥3 cm has been shown as poor prognostic factor in LACC. To assess the efficacy and safety of patients treated for cervical cancer ≥ 3cm N0 and evaluate prognostic factors. Methodology Retrospective, monocentric study. inclusion criteria were patients older than 18-y, biopsy-proven carcinoma of the uterine cervix, tumour size ≥ 3cm, N0, M0. Between 01/2016 and 12/2021, 253p were included and treated with Radiochemotherapy (RCT) (weekly intravenous cisplatin 40 mg/m2, 5–6 cycles, 1 day per cycle, plus 45–50 Gy external-beam radiotherapy delivered in 1·8–2 Gy fractions) followed by intracavitary/interstitial image guided adaptative brachytherapy (IGABT) (4 x 7Gy tu High Risk Clinical Target Volume). Results Median follow-up was 37.7 months. In all population DFS at 1-year (95%CI) was 88.8% (84.2–92.1), DFS at 3-year (95%CI) 75.2% (69.0–80.4), DFS at 5-year (95%CI) 67.5% (59.6–74.2). OS at 1-year (95%CI) was 97.3% (94.5–98.7), OS at 3-year (95%CI) 82.3% (77.4–87.3), OS at 5-year (95%CI) 77.1% (70.3–82.5). Cumulative incidence of local control at 1-year (95%CI) was 4.4% (2.3–7.4), at 3-year (95%CI) 10.3% (6.8–14.6), at 5-year (95%CI) 16.9% (11.4–23.4). The most frequent acute toxicities were rectitis (59.6%) including 2.4% of grade 3 then cystitis 38.4% then pain 30.9%. Late grade 3 rectitis or cystitis and fistula toxicities affected 1.3%, 0.9%, 6.5% of patients respectively. A quarter of the patients (25.2%) have chronic sexual dysfunction. Univariate analyses revealed that poor DFS was associated with adenocarcinoma (HR= 1.65, 95%CI 0.98–2.78, p=0.016). Favourable DFS was associated with lymph node dissection (HR 0.33 95%CI 0.19–0.55, p < 0.001). Conclusion Patients treated by RCT and IGABT for cervical cancer ≥ 3cm N0, presents an excellent local control. We find a benefit in terms of DFS for patients who performed aortic lymph node dissection. Disclosures No disclosures