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Introduction: Advanced cervical cancer (CC) remains a major health problem in our country, with an increasing percentage being diagnosed in young women. Objective: The objective of this study is to present an institutional experience with standard treatment in menstruating women with CC at stages IB2 and IIB, with complementary or rescue surgery being added in selected cases, as well as to propose some management alternatives for these patients. Materials and methods: Analysis of the cases of 45-year-old or younger stage IB2-IIB CC patients who received concomitant chemotherapy and radiotherapy with or without further surgery at the Oncology Department of the Hospital General de México. Results: Ninety-eight patients with a mean age of 37.1 years were treated. In 89 patients, there was follow-up data available, of which 63 (70.7%) had an average evolution of 30 months with no evidence of disease: 12/19 (63.1%) were at stage IB2 and 51/70 (72.8%) at stage II (p > 05). At stage IB2, only 4/8 adenocarcinomas (50%) had these results versus 8/11 (72.7%) squamous cell carcinomas (p > 05). At stage II, the figures were 8/11 for adenocarcinomas (72.7%) and 43/59 for squamous cell carcinomas (72.8%). With further surgery, the results were increased by 10.1%. Failure of established therapeutics was demonstrated in 17 patients (19.3%): 4 cases due to locoregional progression (23.5%) and 13 (76.4%) due to distant dissemination. Conclusions: The results for stage IB2 were inferior to those for stages II, with most failures being related to distant metastasis. To prevent early menopause, exploring the use of neoadjuvant chemotherapy plus radical hysterectomy is recommended in younger patients. (creativecommons.org/ licenses/by-nc-nd/4.0/).

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Gaceta Mexicana de Oncologia. 2017;16(3):160-166 Resumen Introducción: El cáncer cervicouterino (CaCu) avanzado continúa representando en nuestro país un importante problema de salud. Un porcentaje cada vez mayor se diagnostica en mujeres jóvenes. Objetivo: Mostrar una experiencia institucional con la terapéutica convencional en pacientes menstruantes con CaCu en estadios IB2-IIB, agregando en casos indicados cirugías complementarias o de rescate y proponer para estas pacientes alguna alternativa quirúrgica de manejo. Material y métodos: Análisis de la casuística del Servicio de Oncología del Hospital General de México de pacientes de CaCu IB2-IIB con 45 años de edad o menos, que recibieron radioterapia y quimioterapia concomitante (RTQTCC) con o sin cirugía ulterior. Resultados: Se trataron 98 pacientes con edad promedio de 37.1 años. En 89 de ellas se realizó seguimiento, de las cuales 63 (70.7%) evolucionaron un promedio de 30 meses sin evidencia de enfermedad: 12/19 (63.1%) en estadio IB2 y 51/70 (72.8%) en estadios II (p > 0.05). En estadio IB2, únicamente 4/8 adenocarcinomas (50%) tuvieron estos resultados, vs. 8/11 (72.7%) carcinomas epidermoides (p > 0.05). En estadios II, las cifras fueron 8/11 para los adenocarcinomas, (72.7%) y 43/59 para los epidermoides (72.8%). Con cirugías ulteriores los resultados se mejoraron en un 10.1%. Se demostró fracaso de la terapéutica establecida en 17 pacientes (19.3%). Cuatro por progresión locorregional (23.5%) y 13 (76.4%) por diseminación a distancia. Conclusiones: Los resultados para el estadio IB2 fueron menores a los de los estadios II y la mayoría de los fracasos se relacionaron con metástasis a distancia. A fin de evitar menopausias precoces, se sugiere explorar el empleo de quimioterapia neoadyuvante más histerectomía radical en pacientes jóvenes. (creativecommons.org/licenses/by-nc-nd/4.0/). Abstract Introduction: Advanced cervical cancer still represents a major health problem in our country. The percentage diagnosed in young women has been increasing. Objective: We present our institutional experience with conventional therapy in menstruating patients with advanced cervical cancer (stages IB2-IIB); adding in selected cases complementary or rescue surgery as indicated, and our proposal for alternative surgical management for these patients. Methods: We analyzed the cases attended in the Oncology Service, at Hospital General de PALABRAS CLAVECáncer cervicouterino pacientes jóvenes KEY WORDSCervical Cancer Stages IB2-IIB In young patients