Recurrence of invasive cervical carcinoma more than 5 years after initial therapy

OBJECTIVE: To estimate the probability of and risk factors for the recurren ce of invasive cervical carcinoma over 5 years after initial therapy. METHODS: Patients (n = 827) with invasive cervical carcinoma were treated a nd received follow-up care for up to 29 years. Late recurrence was defined as recurrence more than 5 years after initial therapy. The probability of l ate recurrence was evaluated in terms of clinical stage, histologic type, a nd type of initial therapy. RESULTS: Late recurrence was seen in 21 of 569 patients who had survived 5 years (3.7%). Recurrence rates were 1.8% (six of 331) in stage I, 5.2% (eig ht of 154) in stage II, 8.6% (seven of 81) in stage III, and 0% (none of th ree) in stage W. The probability of late recurrence in patients with stage I disease was significantly lower than that in stage H and stage M diseases (stage I compared with stage II, P =.038, stage I compared with stage III, P =.002). Late recurrence occurred in 21 (3.8%) of 547 cases of squamous c ell carcinoma, whereas no late recurrences were found in 22 cases of adenoc arcinoma. The late recurrence rate in patients who received radiation (7.1% , 17 of 241) was significantly higher than that in patients who received su rgery (1.2%, four of 328; P =.001). CONCLUSION: Patients with uterine cervical squamous cell carcinoma, especia lly those with stage II or stage III diseases who received radiation therap y as initial treatment, warrant annual follow-up care beyond the standard 5 years after initial therapy. (C) 2001 by the American College of Obstetric ians and Gynecologists.)