AccScience Publishing / EJMO / Online First / DOI: 10.36922/EJMO025390409
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ORIGINAL RESEARCH ARTICLE

Clinical study of concurrent chemoradiotherapy for remedial treatment of occult invasive cervical cancer: A long-term retrospective study

Zhiru Li1 ,  Dong Yang2,3 ,  Junmei Song2,3 ,  Chao Li4*
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1 Department of Oncology, Sichuan Provincial People’s Hospital and Qionglai Medical Center Hospital, Chengdu, Sichuan, China
2 Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
3 Guangxi Tumor Radiation Therapy Clinical Medical Research Center, Nanning, Guangxi, China
4 Department of Obstetrics and Gynecology, Sichuan Provincial People’s Hospital and Wenjiang District People’s Hospital, Chengdu, Sichuan, China
EJMO, 025390409 https://doi.org/10.36922/EJMO025390409
Received: 22 September 2025 | Revised: 4 June 2026 | Accepted: 18 June 2026 | Published online: 10 July 2026
© 2026 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC-by the license) ( https://creativecommons.org/licenses/by-nc/4.0/ )
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Abstract

Introduction: Occult invasive cervical cancer (OICC) is occasionally detected after simple extrafascial hysterectomy, lacking unified optimal salvage management guidelines. Radical reoperation and remedial concurrent chemoradiotherapy are two mainstream strategies, while their long-term survival and toxicity differences remain insufficiently clarified.

Objective: To compare the efficacy and side effects of concurrent chemoradiotherapy with radical reoperation for OICC salvage treatment.

Methods: Seventy-four patients with OICC who underwent extrafascial hysterectomy between 2013 and 2024 at three hospitals were enrolled. Forty patients received radical concurrent chemoradiotherapy plus 3D intracavitary brachytherapy (radiotherapy group); 34 underwent abdominal/laparoscopic radical hysterectomy plus pelvic ± para-aortic lymphadenectomy, among whom 10 received adjuvant chemoradiotherapy for high-risk factors (surgery group). Recurrence, survival, surgical and radiochemotherapy-related toxicities were analyzed.

Results: Median follow-up was 48 (15–106) months (surgery group) and 56 (21–112) months (radiotherapy group), with four recurrent patients in each cohort. No significant intergroup differences were found in 5-year overall survival (94.5% vs. 93.5%, p = 0.728) and disease-free survival (88.1% vs. 86.7%, p = 0.789). Distinct mild-to-moderate treatment-related complications were observed in both groups, with only rare grade 3 toxicities in the radiotherapy group and no severe long-term adverse events.

Conclusion: Radical reoperation and salvage concurrent chemoradiotherapy yield equivalent curative outcomes for post-hysterectomy OICC with tolerable complications. Adjuvant chemoradiotherapy after reoperation increases complication risks, which may be alleviated via precise radiotherapy techniques.

Keywords
Chemoradiotherapy
Surgery
Occult
Cervical cancer
Funding
This work was supported by the Chengdu Medical Research project in 2023 by the Chengdu Health Commission (No. 2023406) and the 2023 Sichuan Medical Association Youth Innovation Research Project (No. Q23075).
Conflict of interest
The authors declare no competing interests.
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Eurasian Journal of Medicine and Oncology, Electronic ISSN: 2587-196X Print ISSN: 2587-2400, Published by AccScience Publishing
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