[Advanced cervical cancer: Evolutionary and prognostic. Moroccan experience]. / Cancer avancé du col utérin : aspects évolutif et pronostique. Expérience marocaine.

INTRODUCTION: Standard treatment of locally advanced cervical carcinoma is actually represented by concomitant chemoradiotherapy followed by brachytherapy. However, in spite of good local control rates after treatment, local and regional relapses still a major cause of failure treatment. The occurrence of progressions and relapses depends on prognostic factors of disease evolution. Their treatment is often palliative. METHODS: The aim of this study is to report the evolution of our retrospective series after radiotherapy with or without concomitant chemotherapy, and to discuss progressions and relapses factors for the stages IIIB and IVA of cervical carcinoma. RESULTS: Progressions occurred in 15 patients (13.7%) with an average of three months. Recurrences occurred in 15 patients (13.7%) with an average of 19.6 months. The overall treatment failure rate was 27.5%. Seventy-six of treated patients were in good locoregional control with a median follow of 64 months (61-76). The overall survival at five years was 41.3%. CONCLUSION: Relapses of cervical cancer have a poor prognosis and long-term survival remains very poor. The suitable treatment of the primary disease, respecting essentially therapeutic times, is the only guarantee of a good prognosis, as well as screening at early stages, involving less poor prognostic factors.