Clinical Aspects and Prognostic Factors for Survival in Patients with Recurrent Cervical Cancer after Radical Hysterectomy

Abstract

Background: The aim of this study was to investigate the clinical aspects and prognostic factors for survival in patients with recurrent cervical cancer after radical hysterectomy with node dissection (RHND) for stages IA2-IB1. Patients and Methods: Clinicopathologic characteristics of the primary tumor, pattern of recurrence, method of detection, salvage treatment, and outcome were reviewed from the medical records of patients who underwent RHND between 1987 and 2015. Prognostic factors were identified using a Cox regression model. Results: Of 702 patients enrolled in the study, 84 (11.9%) had recurrence. 58, 17, and 9 patients had locoregional, distant, and combined recurrence, respectively. No association between clinicopathologic features and recurrence patterns was observed. Most recurrence patients (63.1%) complained of symptoms prior to examination. The majority of asymptomatic recurrence patients (71.4%) were diagnosed by physical and/or pelvic examination. 5-year overall survival after recurrence (SAR) was 34.3%. On multivariate analysis, pattern of recurrence (p = 0.003), symptom status (p = 0.011), age (p = 0.035), and white blood cell (WBC) count (p = 0.017) were independent prognostic factors for overall SAR. Conclusion: Only pattern of recurrence, symptom status, age, and WBC count were found to be prognostic factors in recurrent cervical cancer after RHND. Follow-up programs after RHND should be directed toward early detection of recurrence.

Prognostic factors for post-recurrence survival among patients with locally advanced cervical cancer who underwent definitive concurrent chemoradiation

“…Regarding symptoms at recurrence, the majority of those with recurrence (81.4%) in the current study had symptoms at the diagnosis of recurrence, which is in line with a previous study of early-stage cervical cancer from the same institute, which found more cases of symptomatic (63.1%) than asymptomatic (33.3%) recurrence [16]. In the current study, physical/pelvic examination was able to detect a high percentage of cases of asymptomatic recurrence (44.2%).…”

Late Recurrence of Early Stage Cervical Cancer more than 3 Years after Radical Hysterectomy with Pelvic Node Dissection

“…The impact of earlier diagnosis of late recurrence of cervical cancer on better clinical outcome is beyond the scope or objective of our study. However, we previously reported that symptom status was found to be prognostic factor in recurrent cervical cancer after radical surgery [27]. Thus, surveillance focusing on different target organs by careful physical examination (especially inguinal node palpation) and appropriate investigations such as chest X-ray and bone survey may be necessary additions to a routine surveillance program for patients with clinical findings and/or symptoms of late rec urrence.…”

Preoperative Neutrophil-Lymphocyte Ratio and Platelet-Lymphocyte Ratio Are Not Clinically Useful in Predicting Prognosis in Early Stage Cervical Cancer

“…Pretreatment WBC count of >10,000/ μ l without known inflammatory condition or infectious disease was diagnostic for tumor-related leukocytosis. Thrombocytosis was defined as a pretreatment PLT count of >400,000/ μ l without a known inflammatory condition [25].…”