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The efficacy of surgical treatment of recurrent or persistent cervical cancer that develops in a previously irradiated field: a monoinstitutional experience

International Journal of Clinical Oncology volume 22, pages 927–936 (2017)Cite this article

Abstract

Background

There are no guidelines about the selection of recurrent cervical cancer patients for salvage surgery.

Methods

Patients who developed recurrent or persistent cervical cancer in a previously irradiated field and were subsequently treated with salvage surgery (the surgery group) or palliative care alone (the palliative group) were identified. Patient characteristics, treatment-related complications, and survival were retrospectively compared between the two groups.

Results

A total of 79 patients (surgery group, n = 51; palliative group, n = 28) were identified. In the surgery group, no intraoperative complications or treatment-related deaths occurred. Eleven patients (21.6%) experienced severe postoperative complications. After a median follow-up period of 41.5 months, 23 patients (45.1%) had developed recurrent disease, predominantly at distant sites, and 19 patients (37.3%) had died of disease progression. The estimated 3-year progression-free survival (PFS) and overall survival rates of the surgery group were 50.4 and 56.5%, respectively. In the palliative group, all of the patients died of disease progression. Positive surgical margins and lymph node metastasis were found to be independent prognostic factors for PFS in the surgery group. Among the patients with no or one poor prognostic factor, the patients in the surgery group survived significantly longer than those in the palliative group. However, among the patients with 2 poor prognostic factors, the surgery group and palliative group displayed similar survival periods.

Conclusions

Salvage surgery is a curative treatment in recurrent or persistent cervical cancer patients. However, considering its high surgical complication rate, salvage surgery should only be offered to carefully selected patients.

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Affiliations

  1. Departments of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan

    Seiji Mabuchi, Yuri Matsumoto, Naoko Komura, Masaaki Sawada, Mie Tanaka, Eriko Yokoi, Katsumi Kozasa, Akihiko Yoshimura, Hiromasa Kuroda & Tadashi Kimura

Authors
  1. Seiji Mabuchi
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  2. Yuri Matsumoto
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  3. Naoko Komura
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  4. Masaaki Sawada
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  5. Mie Tanaka
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  6. Eriko Yokoi
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  7. Katsumi Kozasa
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  8. Akihiko Yoshimura
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  9. Hiromasa Kuroda
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  10. Tadashi Kimura
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Correspondence to Seiji Mabuchi.

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Mabuchi, S., Matsumoto, Y., Komura, N. et al. The efficacy of surgical treatment of recurrent or persistent cervical cancer that develops in a previously irradiated field: a monoinstitutional experience. Int J Clin Oncol 22, 927–936 (2017). https://doi.org/10.1007/s10147-017-1134-x

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  • DOI: https://doi.org/10.1007/s10147-017-1134-x

Keywords

  • Recurrent or persistent cervical cancer
  • Salvage surgery
  • Palliative care
  • Surgical outcome
  • Oncological outcome