Transarterial therapy facilitates surgical conversion in locally advanced cervical cancer

To evaluate the feasibility, tumor response, and surgical conversion of transarterial intervention as a neoadjuvant bridging strategy for selected locally advanced (LACC) or recurrent cervical cancer patients unsuitable for, intolerant to, or derived limited benefit from standard concurrent chemoradiotherapy (CCRT). This single-center retrospective study analyzed 31 patients with FIGO stage IB1-IVA or recurrent cervical cancer treated with transcatheter arterial infusion (TAI) and/or transcatheter arterial embolization (TAE) from 2016 to 2024. Response was assessed via RECIST 1.1, adverse events via Common Terminology Criteria for Adverse Events (CTCAE) v5.0, and overall survival (OS) via exploratory Kaplan-Meier analysis. The primary endpoint was surgical conversion. The cohort achieved an objective response rate (ORR) of 35.48% (11/31) and a disease control rate (DCR) of 90.32% (28/31). Fourteen patients (45.16%) subsequently underwent radical hysterectomy. In exploratory subgroup analysis, the 50-59-year age group showed a higher objective response rate than patients aged < 50 years (58.33% vs. 15.38%; P = 0.027). Median observed follow-up was 23.92 months. Median OS was 49.5 months with surgical conversion and 22.4 months without conversion ( P = 0.248). Several tumor markers changed significantly after therapy (SCC, CA125, and HE4 decreased; CEA increased; all P < 0.05). Most adverse events were grade 1–2 abdominal pain, nausea/vomiting, or fever; one case of rectovaginal fistula occurred. Transarterial intervention may provide disease stabilization and surgical downstaging in carefully selected patients unable to proceed directly to standard CCRT or radical surgery. Given the retrospective design, small sample size, and heterogeneous treatment histories, these preliminary findings should be regarded as hypothesis-generating and require prospective validation.