title: Clinical Aspects and Prognostic Factors for Survival in Patients with Recurrent Cervical Cancer after Radical Hysterectomy.
abstract: BACKGROUND
  The aim of this study was to investigate the clinical aspects and prognostic factors for survival in patients with recurrent cervical cancer after radical hysterectomy with node dissection (RHND) for stages IA2-IB1.
  
  
  METHODS
  Clinicopathologic characteristics of the primary tumor, pattern of recurrence, method of detection, salvage treatment, and outcome were reviewed from the medical records of patients who underwent RHND between 1987 and 2015. Prognostic factors were identified using a Cox regression model.
  
  
  RESULTS
  Of 702 patients enrolled in the study, 84 (11.9%) had recurrence. 58, 17, and 9 patients had locoregional, distant, and combined recurrence, respectively. No association between clinicopathologic features and recurrence patterns was observed. Most recurrence patients (63.1%) complained of symptoms prior to examination. The majority of asymptomatic recurrence patients (71.4%) were diagnosed by physical and/or pelvic examination. 5-year overall survival after recurrence (SAR) was 34.3%. On multivariate analysis, pattern of recurrence (p = 0.003), symptom status (p = 0.011), age (p = 0.035), and white blood cell (WBC) count (p = 0.017) were independent prognostic factors for overall SAR.
  
  
  CONCLUSIONS
  Only pattern of recurrence, symptom status, age, and WBC count were found to be prognostic factors in recurrent cervical cancer after RHND. Follow-up programs after RHND should be directed toward early detection of recurrence.
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.
authors.forename: Jitti
authors.initials: J
authors.lastname: Hanprasertpong
authors.forename: Ingporn
authors.initials: I
authors.lastname: Jiamset
authors.forename: Alan
authors.initials: A
authors.lastname: Geater
authors.forename: Athithan
authors.initials: A
authors.lastname: Rattanaburi
authors.forename: Sarayut
authors.initials: S
authors.lastname: Thannil
mesh_terms: D000328:Adult; D017677:Age Distribution; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000401:mortality* / Q000706:statistics & numerical data; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000401:mortality* / Q000601:surgery*; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000401:mortality*; D015995:Prevalence; D011379:Prognosis; D016016:Proportional Hazards Models; D012307:Risk Factors; D000071036:Sentinel Lymph Node / Q000601:surgery; D015996:Survival Rate; D013785:Thailand / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000401:mortality* / Q000601:surgery*