Diagnosis of recurrent cervical carcinoma after radical hysterectomy.
A standard surveillance program for cervical carcinoma patients treated with radical hysterectomy is reviewed. Between 1962-1984, 249 patients with stage IB cervical carcinoma treated with radical hysterectomy and pelvic lymphadenectomy were entered in the surveillance program. Of the 27 patients (11%) diagnosed with recurrent carcinoma, 17 (63%) were identified by clinical history, 22 (81%) by physical examination, five (18%) by vaginal cytology, six (22%) by chest radiography, and eight (30%) by renal contrast imaging. Combined clinical history and physical examination identified 24 patients (89%) with recurrent carcinoma. Disease recurrence was detected by vaginal cytology in one asymptomatic patient with a normal examination. The recommended surveillance procedures for patients with cervical carcinoma after radical hysterectomy include clinical history, physical examination, and vaginal cytology. Chest radiography and renal contrast imaging should be reserved for symptomatic patients.
Larson
D M
DM
Department of Gynecology, University of Texas M.D. Anderson Hospital and Tumor Institute, Houston.
Copeland
L J
LJ
Malone
J M
JM
Stringer
C A
CA
Gershenson
D M
DM
Edwards
C L
CL
D003581:Cytodiagnosis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy; D007668:Kidney / Q000000981:diagnostic imaging; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary; D008207:Lymphatic Metastasis / Q000175:diagnosis / Q000000981:diagnostic imaging; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000000981:diagnostic imaging; D010146:Pain; D013902:Radiography, Thoracic; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000601:surgery; D014621:Vagina / Q000473:pathology