title: Long-term results of salvage radiotherapy for the treatment of recurrent cervical carcinoma after prior surgery.
abstract: OBJECTIVE
  Tumor recurrence after surgery for cervical carcinoma is associated with high fatality and morbidity, forming a major therapeutic challenge. This paper presents our experience with treatment of this patient group by salvage radiotherapy with curative intent.
  
  
  METHODS
  Thirty-five patients with a pelvic recurrence after hysterectomy received high-dose radiotherapy. A retrospective analysis of long-term outcome and prognostic factors was performed.
  
  
  RESULTS
  After a median follow-up period of 12.1 years, actuarial 2-,5- and 10-year overall survival rates were 66%, 43% and 33%; disease-free survival rates were 62%, 45% and 41%, respectively. Pelvic control rates at 2-,5- and 10-years were 77%, 69% and 62%. Unfavorable prognostic factors on univariate analysis for survival were: recurrence extending to the pelvic wall versus central recurrence, early recurrence after surgery, external boost versus brachytherapy boost, low total dose and high age. Only a brachytherapy boost and a long interval between surgery and recurrence were significant on multivariate analysis. Severe complications (> or = grade 3) were seen in 6 patients (17%; actuarial after 5 years, 21%).
  
  
  CONCLUSIONS
  Salvage radiotherapy for recurrent cervical carcinoma following surgery may result in 40-50% long-term disease-free survival and an acceptable risk of severe treatment complications, even in patient with recurrences extending to the pelvic wall.
authors.affiliation: Department of Radiotherapy, Academic Medical Center, Amsterdam, The Netherlands. cja.haasbeek@vumc.nl
authors.forename: Cornelis J A
authors.initials: CJ
authors.lastname: Haasbeek
authors.forename: Apollonia L J
authors.initials: AL
authors.lastname: Uitterhoeve
authors.forename: Jacobus
authors.initials: J
authors.lastname: van der Velden
authors.forename: Dionisio González
authors.initials: DG
authors.lastname: González
authors.forename: Lukas J A
authors.initials: LJ
authors.lastname: Stalpers
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000532:radiotherapy*; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D016879:Salvage Therapy / Q000379:methods*; D015996:Survival Rate; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery