Adjuvant hysterectomy following unsuccessful intracavitary brachytherapy in cervical carcinoma

e16543 Background: In cervical carcinoma unsuccessful intracavitary brachytherapy (ICBT) treatment results in sub-optimal chemoradiation (CRT) thus increasing risk of recurrence. Optimal management following unsuccessful ICBT remains undefined. Methods: Retrospective analysis of all women with cervical carcinoma treated from January 2000-July 2007 where ICBT insertion was unsuccessful following initial pelvic external beam radiotherapy (EBRT). Data collected and analysed included histology, stage of disease, response to initial CRT, cause for unsuccessful ICBT insertion and subsequent treatment received, morbidity, and recurrence and survival rates. Results: ICBT insertion was unsuccessful in 18 out of 207 (8.7%) women. Causes of failure included: unable to dilate cervix (3); uterine perforation (2); vesicovaginal fistula (2); patient refusal (3); other problems, e.g., pyometrium (4); consultant choice- no obvious reason (4). 13/18 women (72%) received further pelvic EBRT alone. The remaining 5 women (28%...