Prognostic Factors and Therapeutic Failures in Patients with Advanced Loco-Regional Cervical Cancer Treated in the “Prof. Dr. Ion Chiricuţă” Institute of Oncology, Cluj-Napoca” Ioana Lupse 1 , Diana-Cristina Pop 1,2 , Cosmin Lisencu 1 , Alexandru Traila 1 , Mihai Muresan 1,2 , Nicolae Todor 1 , Viorica Magdalena Nagy 1,2 , Claudia Ordeanu 1 1) „Prof. Dr. I. Chiricuta” Institute of Oncology Cluj Napoca; 2) “Iuliu Hatieganu” University of Medicine and Pharmacy Cluj Napoca INTRODUCTION Cervical cancer is an important health problem in Romania, with a incidence of 28.7%000 and a mortality of 10.8%000. In our country, this type of cancer represents 15% of the malignant tumors and it represent 67% among original studies Journal of Radiotheraphy & Medical Oncology March 2016 Vol.22 No 1:5-9 Address for correspondence: Diana-Cristina Pop “Prof.Dr.Ion Chiricuţă” Institute of Oncology Cluj-Napoca Republicii Str, no.34-36 Email: pop_dianacristina@yahoo.com Purpose: To investigate the clinical and histological features that may affect the survival of the patients with advanced loco-regional cervical cancer and to evaluate the therapeutic failures corellated with these factors. Materials and methods: From January 2005 to December 2009, 222 patients with advanced loco-regional cervical cancer were treated with exclusive concurrent radiochemotherapy (RTCT)(68.92%) or concurrent RTCT followed by radical hysterectomy (RTCT-S)(31.08%) in the Brachytherapy department. The median age was 51 years (range: 23-77 years). The median follow up period was 55 months (range: 3.6- 84 months). Forty nine patients (22.07%) had MD Anderson Cancer Centre (MDACC) stage IIB, 87 (39.19%) had stage IIIA and 86 (38.74%) had stage IIIB disease. Two hundred ffteen patients (96.85%) had histology of squamous cell carcinoma, 4 (1.80%) had adenocarcinoma and 3 (1.35%) had small cell carcinoma. Tumor size was < 5 cm in 100 patients (45.04%) and ≥ 5 cm in 122 patients (54.96%). Results: Local and distant control was obtained in 91.44% and 86.49% respectively. Local recurrence appeared for 8.56% of the patients and distant metastases for 13.51%. Increasing MDACC stage (p=0.04) and larger clinical tumor diameter (p=0.02) were statistically signifcantly related with more frequent failures. The 5- year overall survival (OS) for patients with stage IIB, IIIA and IIIB were 88%, 79% and 64% (p=0.01), respectively. The 5- year OS for patients with tumor diameter < 5 cm and ≥ 5 cm were 83% and 69% (p=0.01) respectively. The 5-year OS for the subgroup treated with RTCT and with RTCT-S were 84% and 72% (p=0.06) respectively. Conclusion: Patients with loco-regional advanced cervical carcinoma clinical features (stage and tumor diameter) are strongly correlated with the therapeutic outcome, statistically signifcant. Key words: advanced cervix cancer, prognostic factors, therapeutic failures. the gynecological cancers and the second cause of mortality caused by cancer in women [1]. The main cause of cervical cancer is infection with high-risk HPV, with its DNA being discovered in the vast majority of the cases [2]. Mortality from cervical cancer ranks third among all cancers in females. Over 85% of deaths due to cervical cancer are registered in less developed countries [3]. Among new diagnosed and treated tumors at the “Prof. Dr. Ion Chiricuţă” Institute of Oncology Cluj-Napoca, cervical cancer is the second most common in women. 70% of these new diagnosed cases are in advanced stages. For this reason a multidisciplinary approach in the treatment of cervical cancer represents a real problem.