RECURRENT CERVICAL-CARCINOMA AFTER RADICAL HYSTERECTOMY - AN ANALYSISOF CLINICAL ASPECTS AND PROGNOSIS

The purpose of the present study was to evaluate the clinical aspects and prognosis of patients with tumor recurrence in surgically treated stage IB and IIA cervical carcinoma patients. Two hundred and seventy- one stage IB and IIA cervical carcinoma patients underwent a Wertheim Okabayashi radical hysterectomy with pelvic lymyphadenectomy. The medi an follow-up time was 60 months. Recurrence occurred in 27 patients (1 0%): 14 had a pelvic recurrence and 13, and extrapelvic recurrence. Th e site of recurrence was influenced by various pathological factors as well as by the primary treatment mode. 77% of recurrences were detect ed within three years after primary treatment. The median recurrence-f ree interval in patients with a pelvic recurrence was significantly sh orter than in patients with an extrapelvic recurrence (14 months vs. 1 7 months, P = 0.03). The mortality rate of the group of patients with recurrent disease was 85% (23/27), Patients with a pelvic central recu rrence had a significantly better outcome than did patients whose recu rrences were located at the pelvic sidewall. Two patients with a pulmo nary recurrence were treated with surgery and show no evidence of dise ase after 4 and 8 years respectively, of follow-up. The overall detect ion rate of recurrent disease by routine follow-up was only 36%. Howev er, asymptomatic patients had a significantly better prognosis when co mpared with symptomatic patients. Therefore, we recommend frequent fol low-up visits during the first 3 years after primary treatment to dete ct recurrence in an early stage.