Clinical patterns of tumor recurrence after radical hysterectomy in stage ib cervical carcinoma

We reviewed the cases of 31 patients with International Federation of Gynecology and Obstetrics (FIGO) stage IB cervical carcinoma who developed recurrent disease after radical hysterectomy and pelvic lymphadenectomy between 1961 and 1982. The overall incidence of recurrence was 11.3%. Recurrence was significantly more common in patients with adenocarcinoma or adenosquamous carcinoma (17.4%) than in those with pure squamous tumors (9.2%). The median time from operation to recurrence was eight months. The median survival of patients dying of disease was 18 months. Sites of recurrence were categorized as central pelvic in 35% of cases, pelvic sidewall in 39%, and distant in 26%. Patients treated with postoperative pelvic radiotherapy for positive pelvic nodes or surgical margin involvement were more likely to develop distant recurrence. Various therapeutic modalities were used to treat recurrent disease. Twenty-two of 23 patients with central pelvic or sidewall recurrence failed radiation therapy. None of four patients with central recurrence treated by pelvic exentera-tion survived. No patient treated with chemotherapy survived. Overall survival for patients with recurrence was 3.2%. The dismal prognosis for this group of patients warrants evaluation of alternative treatment modalities.