Research for Recurrence After Radical Hysterectomy and Pelvic Lymph Node Dissection for Cervical Cancer

Yoon, H H; Jin, K S; Lee, S K; Kim, S B

Abstract

The incidence of recurrence in early stage cervical carcinoma is 10~20%. Approximately 15% of patients who have recurrence will survive 2 years free of disease after additional therapy. Several prognostic factors associated with an increased risk of recurrence have been determined. Few reports have dealt with the clinical nature of recurrence following radical surgery. This paper review, in a retrospective manner, radical hysterectomy and pelvic lymphadenectomy for early stage cervical cancer. The women who recurred after radical hysterectomy and pelvic lymphadenectomy during the follow-up period were 25 cases (16.8%). Our results are as follows; Histopathologic distribution are as follows: squamous cell carcinoma 15.7%, adenocarcinoma 25.0%, adenosquamous cell carcinoma 33.0%. Anatomic site of recurrence are as follows ; central pelvic recurrence are 10 cases (40.0%), lateral pelvic recurrence are 5 cases (20.0%), distant recurrence are 10 cases (40.0%). Adjuvant radiation therapy after radical hysterectomy and pelvic lymphadenectomy significantly reduced the pelvic recurrence comparing to surgery alone (42.8% vs 81.8%) ( p < 0.05 ). The incidence of recurrence are higher when in advanced stages, lymph node metastasis is seen (36.8% vs 10.0%), and the primary therapeutic modality is surgery plus adjuvant radiation therapy (26.9% vs 11.4%). Tumor size ( > 4 cm) is significantly related with recurrence (8.0% vs 44.4%) (p < 0.05). Mean disease free interval according to primary therapeutic modality, recurrence site, nodal status, FIGO stage are as follows ; surgery alone compared to surgery plus radiation (22.2 months vs 12.7 months), pelvic recurrence compared to distant recurrence (20 months vs 13 months), lymph node negative compared to positive (22.4 months vs 12.6 months), FIGO stage Ib, IIa, IIb (20.3 months vs 14.2 months vs 11 months). Overall cumulative survival rate are as follows; within 6 month is 80%, within 1 year is 48%, within 2 year is 20%, and 5-year survival rate is 16%. The purpose was to evaluate which.