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.