Value of routine follow-up procedures for patients with stage I/II cervical cancer treated with combined surgery-radiation therapy.
BACKGROUND
The aim of this study was to determine the value of routine follow-up for the detection of recurrence in patients treated for cervical cancer.


METHODS
From 1986 to 1998, 583 women with stage I and II cervical carcinoma were treated with combined surgery-radiation therapy. After treatment, follow-up was based on clinical examination, a systematic Pap smear and radiography (chest X-ray and abdomino-pelvic ultrasonography).


RESULTS
Forty-five patients had recurrence observed with a delay > or = 6 months following the end of treatment. Thirty-eight patients had symptoms and seven were asymptomatic at the time of their recurrence. Among asymptomatic patients only two recurrences were diagnosed following routine examinations. Survival is similar in asymptomatic and symptomatic recurrent patients.


CONCLUSIONS
In conclusion, follow-up of patients treated for cervical cancer based on routine Pap smears and systematic radiography does not permit earlier detection of recurrence and does not increase survival.
Morice
P
P
Department of Gynecologic Surgery, Institut Gustave Roussy, Villejuif, France. morice@igr.fr
Deyrolle
C
C
Rey
A
A
Atallah
D
D
Pautier
P
P
Camatte
S
S
Thoury
A
A
Lhomme
C
C
Haie-Meder
C
C
Castaigne
D
D
D000230:Adenocarcinoma / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D000328:Adult; D000368:Aged; D018196:Carcinoma, Adenosquamous / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D065006:Papanicolaou Test; D010808:Physical Examination; D011379:Prognosis; D013902:Radiography, Thoracic; D012189:Retrospective Studies; D016019:Survival Analysis; D014463:Ultrasonography; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D014626:Vaginal Smears