<h3>Objectives</h3> In Haiti, a low-resource setting where radiotherapy is unavailable, significant numbers of women present with locally advanced cervical cancer in need of treatment. We built a multidisciplinary team to collaboratively implement neoadjuvant chemotherapy followed by surgery, and aimed to retrospectively assess the efficacy and feasibility of this approach. <h3>Methods</h3> We implemented paclitaxel/carboplatin neoadjuvant chemotherapy (NACT) followed by radical surgery for women with stage IB2-IIA cervical cancer at the Hospital Universitaire de Mirebalais (HUM). Three Haitian gynecologists worked remotely with expert clinicians to pilot the program. We aimed to determine the feasibility and safety of this approach in this resource limited setting. <h3>Results</h3> Between January of 2021 and May of 2022, 26 of 310 women diagnosed with cervical cancer at HUM received NACT followed by radical surgery. Women in the pilot sample were ages 38 to 69 years. Twenty-three received six cycles of chemotherapy, while the remainder received three cycles. As of May 2022, 16 had undergone radical surgery, three were lost to follow-up during chemotherapy, two were inoperable, and five were receiving chemotherapy. Of women undergoing radical surgery, two were found to have metastatic disease during surgery and one was found to have a recurrence of disease. There were no perioperative deaths. One woman experienced sepsis and developed a vesicovaginal fistula. <h3>Conclusions</h3> Preliminary results suggest that NACT followed by radical surgery is feasible and safe in a resource limited setting, and may improve the chance for cure for women who otherwise might be offered comfort measures only. 

https://ijgc.bmj.com/content/ijgc/32/Suppl_3/A81.1.full.pdf

EP081/#1043 Cervical cancer treated by neoadjuvant chemotherapy followed by radical surgery: a case series from mirebalais, Haiti

Placental trophoblastic site tumor is a rare type of gestational trophoblastic neoplasia. PSTT has a higher mortality than other types of GTD, with a rate of 16.1%, due to its relatively unpredictable behavior and reduced response to chemotherapy. It diagnostic and management are very challenging in Low resources settings particularity in Haiti where MRI, PET Scan and IHC are not available. Further, the follow-up is very difficult because of social, political, and economic issues limiting the capacity of our patients to be present at all scheduled visits. No case of PSTT has been publicly described yet the Haitian experience in the literature in the management of such case compared to the developed world. We present a case of PSTT successfully diagnosed and managed at MUH in Haiti with the support of telepathology and intentional partners while highlighting the difference that we observed compare to the developed world. 

A Case of Placental Site Trophoblastic Tumor Managed in a Low Resource Setting

Sometimes we are in clinic when we hear the news: a colleague kidnapped on the road to work, a formerly safe neighborhood invaded by violence, our patients fleeing their homes, another area where it is unsafe to travel, where patients are cut off from hospital care. Mirebalais University Hospital ( 

The tug of war: delivering safe gynecologic oncology treatment amid insecurity in Haiti

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EP081/#1043 Cervical cancer treated by neoadjuvant chemotherapy followed by radical surgery: a case series from mirebalais, Haiti

A Case of Placental Site Trophoblastic Tumor Managed in a Low Resource Setting

The tug of war: delivering safe gynecologic oncology treatment amid insecurity in Haiti