ESTRO 38 Abstract book

S436 ESTRO 38

for non-surgery group and 51% for surgery group, again without differences between the groups. However overall survival (OS) was 46.87% in the non surgical group vs 60.75% in the surgical (p=0.0061) (Fig.1), probably due to the worse clinical features related with age, performance status and stage of tumor in the non surgical group (p<0.005).

Conclusion In cervical cancer patients treated with chemoradiation, LMR over and above established prognostic factors including FIGO Stage, hemoglobin and nutritional status seems to be an important independent prognostic factor for DFS and OAS. Further research to get more insights and clinical relevance is warranted. PO-0832 Para-aortic lymphadenectomy and recurrence patterns in locally advanced cervical cancer M.M. Soraya 1 , D.C. Moreno Santiago 1 , J. Giralt Lopez de Sagredo 1 , R. Verges Capdevilla 1 1 Vall D'Hebron, radiation oncologist, Barcelona, Spain Purpose or Objective The aim of this study is to investigate the impact of primary para-aortic lymphadenectomy (PAL) on recurrence patterns in locally advanced cervical cancer patients. Material and Methods Data of all patients with cervical cancer treated in curative intent with external beam and brachytherapy +/- chemotherapy from 2001 to 2016 in our center were included in this retrospective study. Surgical staging was routinely performed before definitive treatment. However, there were some situations according to patient-related, tumor-related or logistic-related in which the surgical staging was not performed. Radiation was delivered to a clinical target volume comprising the uterus, cervix, vagina, parametrial tissues and pelvic nodes. Para-aortic region irradiation was performed only when there were prove of involved nodes by image or surgical staging. Results A total of 207 patients were included. The median follow- up was 39.6 months. Table 1 details clinical characteristics of the population according to surgical staging. Loco-regional and distant image staging was evaluated with MRI (97.1% of patients) and PET-CT (32.7% of patients, n=67), finding in MRI 46% of the patients with nodal affectation and 55.2% (37) in PET-TC, without significative differences in the surgical vs non surgical groups. Para-aortic lymphadenectomy (PAL) via laparoscopic was done in 141 patients (68.1%). Globally 108 (54.5%) patients were diagnosed with pelvic positive and/or PA nodal involvement of which 35 received extended volume radiotherapy, 19% of them without surgical staging and 23% of those operated, without significant differences. Recurrence happened in 68 patients (34%), 23 (35.4%) without surgical staging and 45 (33.3%) with PAL (p=ns). Local recurrence was described in 38.2% (39.1% and 37.8%, without and with PAL respectively; p=ns). The regional recurrence was 38.2%, 30.4% and 42.2 % respectively without significant differences between groups. The distance recurrence appeared in 52.9% to all group, 56.5%

Conclusion In our group, those patients who underwent surgical staging had a better overall survival. However, Primary PAL does not demonstrate an improvement in loco- regional and distant control. This data suggest that PAL without prophylactic extended volume irradiation does not change the patterns of recurrence in patients with locally advanced cervical cancer. PO-0833 Development of a nomogram for predicting overall survival in patients with Cervical cancer A.B.A. Osong 1 1 Maastricht University, Maastro, Hasselt, Belgium Purpose or Objective The International Federation of Gynecologists and Obstetricians (FIGO) stage is a prominent prognostic factor for estimating patient’s survival in cervical cancer. However, several studies have shown that additional clinical and pathologic variables further improve the prognostic performance of patient survival models. These survival models can be graphically represented in nomograms, enabling the estimation of a patient's overall survival (OS) probability based on these factors. However, these models should be contemporary to the additional routine clinical data. In this work, we developed and internally validated a nomogram to predict OS for cervical cancer patients treated with radiotherapy, optionally in combination with hyperthermia or chemotherapy.