Outcomes and prognosis of patients with recurrent cervical cancer after radical hysterectomy

Jian Tai Qiu, Nor Anita Abdullah, Hung Hsueh Chou, Cheng Tao Lin, Shih Ming Jung, Chun Chieh Wang, Min Yu Chen, Kuan Gen Huang, Ting Chang Chang, Chyong Huey Lai

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Objective: Our aim was to investigate the clinical features and outcomes following recurrence after primary radical hysterectomy for cervical cancer. Methods: Clinical data of 121 documented recurrent cervical cancer patients who received primary radical hysterectomy and bilateral pelvic lymphadenectomy between 1993 and 2000 at Chang Gung Memorial Hospital were retrospectively reviewed. Clinicopathological variables, primary treatment, failure pattern, salvage treatment and outcomes were analyzed. Outcomes of the current study were compared to those treated between 1982 and 1992 (1982-1992 cohort). Results: Cancer recurrence was documented at a median time to recurrence (TTR) of 28.4 months (1.2-129.9 months). Assessable failure patterns (n = 106) included loco-regional in 46.3%, distant in 47.2% and combined pelvic-distant in 6.6%. 5-year survival of the 121 patients was 22.3% after cancer recurrence. The median survival after recurrence (SAR) was 16.4 months (range 0-144.2 months). By multivariate analysis, extravaginal sites of recurrence (HR 2.56, 1.28-5.12; p = 0.008) and HPV16-positive (HR 0.60, 0.38-0.96; p = 0.033) were significant prognostic factors for SAR. Non-squamous histology or pelvic node metastasis at primary surgery were not significant (5-year SAR of 16.4% and 20.0%, respectively), though they were (0% and 0%) in the 1993-2000 cohort. Salvage surgery and concurrent chemoradiation were more frequently used in the 1993-2000 cohort (48.3% versus 12.4%). Conclusion: HPV16-negativity and extravaginal relapse were significant poor prognostic factors. Future randomized controlled trials for recurrent cervical cancer could be stratified for these two factors if further studies using external validation confirm these results.

Original languageEnglish
Pages (from-to)472-477
Number of pages6
JournalGynecologic Oncology
Volume127
Issue number3
DOIs
Publication statusPublished - Dec 2012
Externally publishedYes

Keywords

  • Cervical cancer
  • Prognostic factors
  • Recurrence
  • Salvage

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynaecology

Fingerprint Dive into the research topics of 'Outcomes and prognosis of patients with recurrent cervical cancer after radical hysterectomy'. Together they form a unique fingerprint.

  • Cite this

    Qiu, J. T., Abdullah, N. A., Chou, H. H., Lin, C. T., Jung, S. M., Wang, C. C., Chen, M. Y., Huang, K. G., Chang, T. C., & Lai, C. H. (2012). Outcomes and prognosis of patients with recurrent cervical cancer after radical hysterectomy. Gynecologic Oncology, 127(3), 472-477. https://doi.org/10.1016/j.ygyno.2012.08.008