The Efficacy of Salvage Surgery in Patients With Residual Tumor After Concurrent Chemoradiation for Locally Advanced Cervical Cancer.

Inclusion criteria

• Stage Ib3 and IIA2-IVA (FIGO2018) cervical cancer with histopathology of squamous cell carcinoma, adenosquamous cell carcinoma, adenocarcinoma.
• Complete standard CCRT(Pelvic EBRT+ concurrent platinum-containing chemotherapy+ brachytherapy).
• After 4-12 weeks of treatment, the cervical biopsy pathology confirmed residual cancer, or the cervical biopsy was negative, but PET /CT showed that SUVmax of the residual lesions in the cervical and/or pelvic lymph nodes were ≥ 2.5, two or more gynaecological oncologists with Grade IV operation qualification and the title of deputy director or above have gynecological examination, and the multidisciplinary team(MDT) evaluation recommended surgical treatment.
• ECOG score:0 ~ 1.
• The expected survival time>6 months;
• There is no absolute contraindication of surgery and the patients with good compliance.

Exclusion criteria

• The radiotherapy and chemotherapy are not completed or the radiotherapy dose is not reached.
• PET /CT and/or pathological indicates that there is a distant metastasis including para-aortic lymph nodes.
• Other malignancies were diagnosed within five years or needed treatments.
• History of important organ transplantation.
• History of immune disease who need to take immunosuppressive drugs.
• History of serious mental illness and brain functional disorder.
• Drug abuse or drug use history.
• Participants in other clinical trials at the same time.
• Those who are unable or unwilling to accept surgical treatment/sign informed consent/comply with research requirements.
• Without surgical conditions: 1) Chronic renal insufficiency or renal failure; 2) Liver insufficiency; 3)Chronic lung disease with restrictive respiratory dysfunction; 4) Cardiac dysfunction (patients with relative and absolute contraindications to surgery after consultation by cardiac physicians.
• Patients who cannot understand the research regimen and refuse to sign the informed consent form.
• Other concomitant diseases or special conditions seriously endanger the patient's health or interfere with the trial.