MANAGEMENT OF RECURRENT CERVICAL-CANCER - THE PLACE OF ULTRA-RADICAL SURGERY

Although mortality from cervical cancer has decreased substantially th e incidence of recurrent disease, at 35-50%, remains unaltered. Many m ore young patients are seen with recurrent cervical cancer today. This paper reviews this problem-its diagnosis and available modes of treat ment. The place of re-irradiation, chemotherapy and ultra-radical surg ery are discussed and their limitations highlighted. Better patient se lection and individualised treatment planning are emphasised. Newer, m ore objective prognostic indicators based on molecular understanding o f cancer cells are mentioned as hopeful means through which patient se lection and treatment could be improved in the future. In the developi ng world where persistent or recurrent disease is more common, the sit uation is unlikely to improve soon.