title: Post-treatment follow-up procedures in cervical cancer patients previously treated with radiotherapy.
abstract: OBJECTIVE
  We investigated the role of physical examination, CT scan, chest X-ray, and Pap smear in the routine follow-up program for cervical cancer patients previously treated with radiotherapy.
  
  
  METHODS
  The records of women who had developed recurrent cervical cancer after radiotherapy were retrospectively reviewed. The optimal procedure for the detection of recurrence was evaluated according to the disease-free interval (DFI). Survival analysis was performed based on the Kaplan-Meier method and comparisons between groups were made using the log-rank test.
  
  
  RESULTS
  A total of 146 recurrent cervical cancer patients were included in our database. The majority of recurrences were diagnosed either by symptoms, physical examination, or CT scan. The patients whose recurrent disease was detected by Pap smear, physical examination, or CT scan had a significantly longer survival than those detected by symptoms. When analyzed according to DFI, physical examination, and CT scan led to the detection of recurrence in patients with a DFI of 1-5 years. In contrast, chest X-ray and Pap smear only had a clinical impact on the diagnosis of recurrence in patients with a DFI of 1-2 years.
  
  
  CONCLUSIONS
  Chest X-ray and Pap smear can be routinely performed for the first 2 years after radiotherapy, but can be omitted or used sparingly thereafter.
authors.affiliation: Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan, smabuchi@gyne.med.osaka-u.ac.jp.
authors.forename: Seiji
authors.initials: S
authors.lastname: Mabuchi
authors.forename: Fumiaki
authors.initials: F
authors.lastname: Isohashi
authors.forename: Shintaro
authors.initials: S
authors.lastname: Maruoka
authors.forename: Takeshi
authors.initials: T
authors.lastname: Hisamatsu
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Takiuchi
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Yoshioka
authors.forename: Tadashi
authors.initials: T
authors.lastname: Kimura
mesh_terms: D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000473:pathology; D065006:Papanicolaou Test; D010808:Physical Examination; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000532:radiotherapy*