Clinical aspects and prognosis of pelvic recurrence of cervical carcinoma.
OBJECTIVE
To identify which patients with locally recurrent cervical carcinoma are potentially curable.


METHODS
A total of 664 stage IB-IVA patients were examined following surgery or radiotherapy.


RESULTS
Among the 664 patients, 193 (29%) developed recurrence. Sixty-seven (35%) of these recurrences were located in the pelvis alone. Among these 67 recurrences, 24 (35%) were central recurrences and the remaining 43 (65%) were pelvic side-wall recurrences. Of the 24 patients with central recurrences, 8 were salvaged. Of these 8 patients, 3 underwent pelvic exenteration, and 5 received optimal radiotherapy. The recurrent tumor in these 5 survivors who received radiotherapy had consisted of a small (<2 cm) tumor. All 43 patients with pelvic wall recurrence developed progressive disease.


CONCLUSIONS
The following patients are potentially curable: patients with a resectable, centrally located tumor who are candidates for pelvic exenteration, and patients with a small central recurrence for whom complete radiation therapy is feasible.
Kasamatsu
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Division of Gynecology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan. takasama@ncc.go.jp
Onda
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Yamada
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Tsunematsu
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R
D000230:Adenocarcinoma / Q000175:diagnosis / Q000556:secondary / Q000628:therapy; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018196:Carcinoma, Adenosquamous / Q000175:diagnosis / Q000556:secondary / Q000628:therapy; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000556:secondary / Q000628:therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000628:therapy*; D009367:Neoplasm Staging; D010385:Pelvic Exenteration; D010386:Pelvic Neoplasms / Q000175:diagnosis* / Q000556:secondary / Q000628:therapy; D011379:Prognosis; D011878:Radiotherapy; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy