Recurrent cervical cancer: detection and prognosis.

Acta Obstet Gynecol Scand

Department of Obstetrics and Gynecology, Academic Medical Center, Amsterdam, The Netherlands.

Published: August 2002

AI Article Synopsis

  • Only 32% of cervical cancer recurrences were detected during routine follow-up visits; most were identified through patient-reported symptoms (87%).
  • In a study of 277 patients treated for stage IB-IVA cervical cancer, self-referral led to detection in 45% of cases.
  • Disease-free interval (DFI) and treatment modality were significant factors affecting survival following recurrence, but due to variability in treatment types, further analysis was limited.

Article Abstract

Background: Only a small proportion of cervical cancer recurrences is detected during routine follow-up. We investigated which percentage of recurrences is detected during follow-up, which diagnostic tools are helpful to detect recurrent disease and which factors are of prognostic significance once recurrent disease has been established in patients treated for cervical cancer stage IB-IVA.

Methods: Characteristics of the primary tumor, characteristics of recurrent disease and follow-up were collected retrospectively from clinical records of 277 patients who achieved a complete remission of at least 3 months after primary treatment for cervical cancer in 1992, 1993 and 1994 in three university hospitals in the Netherlands.

Results: Of 277 patients, 47 (17%) developed recurrent disease; this was most often detected after self-referral (45%), and in 32% during routine follow-up. Survival did not differ significantly between these two groups. The presence of symptoms (87%) was the most important first abnormal test result leading to diagnosis of recurrence. In univariate analysis, disease-free interval (DFI) and treatment modality were significant prognostic factors for crude survival of recurrence. However, treatment modality varied considerably and the subgroups were small. Therefore, multivariate analysis was not feasible and clinically valid conclusions could not be drawn.

Conclusions: In only 32% of all cases, recurrence was detected during a scheduled follow-up visit. In the majority of patients, recurrent cervical cancer was detected by symptoms (87%). In recurrent disease, DFI was a prognostic factor for survival.

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Source
http://dx.doi.org/10.1034/j.1600-0412.2002.810414.xDOI Listing

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