Clinical Aspects and Prognostic Factors for Survival in Patients with Recurrent Cervical Cancer after Radical Hysterectomy and Adjuvant Radiochemotherapy

Abstract Purpose To investigate the recurrence patterns and prognostic factors of patients with recurrent cervical cancer after radical hysterectomy with node dissection (RHND) followed by adjuvant radiotherapy (RT)/concurrent radiochemotherapy (CCRT). Methods Between January 1, 2012 and May 31, 2018, the medical records of 153 patients with pre-operative FIGO stage IB-IIA disease treated with RHND followed by adjuvant RT/CCRT in Liaoning Cancer Hospital were retrospectively analyzed. Results The median disease progression-free survival (PFS) time was 16 months. 75.2% (115/153) patients had disease relapse within 2 years. The survival of patients with recurrences in multiple organs was signifificantly lower in comparison to those with recurrences in single organ ( P <0.001). The survival rate of patients with distant metastasis (DM) and distant metastasis with local recurrence (LR) was significantly lower than that of patients with simple LR ( P =0.006, P <0.001). Furthermore, the survival rate of patients with LR+DM was significantly lower than that of patients with simple DM ( P =0.046).The multivariate analysis showed that resection margin involvement, para-aortic and common iliac lymph node metastasis, DM, no treatment after disease relapse and early disease relapse were independent prognostic fators asscociated with poor survivals. Conclusion Most cervical cancer patients who received initial RHND followed by adjuvant RT/CCRT occurred disease relapse within 2 years. Resection margin involvement, para-aortic and common iliac lymph node metastasis, DM, no treatment after recurrence and early disease relapse were found to be prognostic factors in patients with recurrent cervical cancer after RHND followed by adjuvant RT/CCRT.