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Recurrence of Invasive Cervical Carcinoma More Than 5 Years After Initial Therapy

From the Department of Obstetrics and Gynecology, National Hospital Kure Medical Center, Chugoku Cancer Center, Kure, Japan; and the Department of Obstetrics and Gynecology, Hiroshima University School of Medicine, Hiroshima, Japan.

Address reprint requests to: Kazushi Shigemasa, MD, PhD, Department of Obstetrics and Gynecology, Hiroshima University School of Medicine, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan; E-mail: kaz{at}mcai.med.hiroshima-u.ac.jp.

OBJECTIVE: To estimate the probability of and risk factors for the recurrence of invasive cervical carcinoma over 5 years after initial therapy.

METHODS: Patients (n = 827) with invasive cervical carcinoma were treated and 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 late recurrence was evaluated in terms of clinical stage, histologic type, and 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% (eight of 154) in stage II, 8.6% (seven of 81) in stage III, and 0% (none of three) in stage IV. The probability of late recurrence in patients with stage I disease was significantly lower than that in stage II and stage III 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 cell carcinoma, whereas no late recurrences were found in 22 cases of adenocarcinoma. The late recurrence rate in patients who received radiation (7.1%, 17 of 241) was significantly higher than that in patients who received surgery (1.2%, four of 328; P = .001).

CONCLUSION: Patients with uterine cervical squamous cell carcinoma, especially those with stage II or stage III diseases who received radiation therapy as initial treatment, warrant annual follow-up care beyond the standard 5 years after initial therapy.

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