title: Abdominal scar recurrences of cervical cancer: incidence and characteristics: a case-control study.
abstract: BACKGROUND
  Tumor recurrence in the surgical scar after radical hysterectomy for cervical cancer has been reported, but the incidence is unknown. Facts about patient and tumor characteristics and follow-up are lacking. The objective of this study was to analyze the incidence and characteristics of cervical cancer scar recurrences.
  
  
  METHODS
  All patients who were surgically treated for cervical cancer in our center between 1984 and 2007 were reviewed for scar recurrences. For each case, 5 random controls were selected. Clinical characteristics were compared between the cases and controls.
  
  
  RESULTS
  Eleven (1.3%) of 842 patients developed a scar recurrence. Mean time between surgery and scar recurrence was 16 months (range, 2-45 months). For 8 patients (73%), the scar recurrence was the first disease recurrence. Five patients (45%) died, and 2 (18%) were lost to follow-up. Mean time between scar recurrence and death was 9 months. Ninety-one percent of the cases had recurrent disease besides the scar recurrence during follow-up. The case group had a higher percentage of advanced FIGO (International Federation of Gynecology and Obstetrics) stage and postoperatively found involvement of parametria or resection margins and tumor diameter greater than 4 cm, whereas lymph nodes were more often involved in the control group.
  
  
  CONCLUSIONS
  The incidence of scar recurrences after primary surgery for cervical cancer was 1.3%. Time to development was variable, and prognosis was poor. Besides higher FIGO stage and concurrent unfavorable pathological characteristics, we found no outstanding characteristics of patients with scar recurrence. Scar recurrences go hand in hand with recurrent disease at other locations and seem a manifestation of tumors with extensive metastatic potential.
authors.affiliation: Department of Gynecology, Leiden University Medical Center, The Netherlands. s.a.h.m.van_den_tillaart@lumc.nl
authors.forename: Sabrina A H M
authors.initials: SA
authors.lastname: van den Tillaart
authors.forename: Annelies
authors.initials: A
authors.lastname: Schoneveld
authors.forename: Inge T
authors.initials: IT
authors.lastname: Peters
authors.forename: J Baptist M
authors.initials: JB
authors.lastname: Trimbos
authors.forename: Astrid
authors.initials: A
authors.lastname: Van Hylckama Vlieg
authors.forename: Gertjan J
authors.initials: GJ
authors.lastname: Fleuren
authors.forename: Alexander A
authors.initials: AA
authors.lastname: Peters
mesh_terms: D034861:Abdominal Wall / Q000473:pathology; D001707:Biopsy, Needle; D016022:Case-Control Studies; D002921:Cicatrix / Q000209:etiology / Q000473:pathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects* / Q000379:methods; D007150:Immunohistochemistry; D015994:Incidence; D016015:Logistic Models; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology* / Q000473:pathology* / Q000601:surgery; D009367:Neoplasm Staging; D016016:Proportional Hazards Models; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000150:complications / Q000401:mortality / Q000473:pathology / Q000601:surgery*