A Retrospective Study for Clinical Characteristics of the Patients with Recurrent Cervical Cancer

Kim, B S; Yoon, C B; Sung, J H; Lee, E H; Ryu, S Y; Kim, J H; Kim, B G; Park, S Y; Rhee, E D; Lee, K H

Abstract

OBJECTIVE
This study was performed to evaluate the survival and clinical characteristics of recurrent cervical carcinoma following initial treatment.
METHODS
From Jan. 1994 to Dec. 1994, total 79 patients were identified to have recurrence by physical examination, Pap smear, radiologic studies (chest PA, CT/MRI) or/and PCNA (percutaneous needle aspiration cytology). Their medical records and cytologic slides were reviewed. The information about survival and disease status was obtained from the last follow-up date in medical records or from interview via telephone.
RESULTS
For the initial FIGO stage of recurrent cervical carcinoma, 18 patients (22.8%) were stage I ; 38 patients (48.1%), stage II; 21 patients (26.6%), stage III; 2 patients (2.5%), stage IV. The recurrent sites in patients with recurrent carcinoma were classified into central pelvic, lateral pelvic, and distant metastasis, and 24 patients (30.4%) showed central pelvic recurrence; 7 patients (8.9%), lateral pelvic recurrence; 48 patients (60.7%), distant metastasis. The most frequent metastatic site was paraaortic LN. For the detection of recurrent tumor, 33 of 79 patients (41.0%) were detected by symtoms and signs; 12 patients (17.0%), by Pap smear; 3 patients (3.1%), by chest PA; 16 patients (20.0%), by routine CT or MRI; 15 patients (18.9%), by PCNA. In these patients, the intervals from completion of initial treatment to recurrence were as follows: within 12 months, 15 patients (18.9%); from 12 months to 24 months, 31 patients (39.3%); from 24 to 36 months, 11 patients (13.9%); above 36 months, 22 patients (27.9%). The median survival of the patients studied was 38 months from the time of the diagnosis of recurrence.
CONCLUSION
These results suggested that the regular follow-up at least 3 years should be made because more than 3/4 of the recurrence developed within 3 years. In addition,the routine diagnostic work-up to detect distant metastasis should be included at appropriate interval in this period. The strategy may improve the survival of the patients with recurrent cervical cancer.