Late Recurrence of Early Stage Cervical Cancer more than 3 Years after Radical Hysterectomy with Pelvic Node Dissection

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Background: The aim of this study was to compare the clinicopathological characteristics and outcomes of patients who developed late recurrence (> 3 years) of early stage cervical cancer after radical surgery with those of patients who developed early recurrence (≤ 3 years). We also investigated the risk factors of late recurrence. Methods: The records of 515 patients with early stage cervical cancer diagnosed between 1999 and 2015 were reviewed. 53 patients developed recurrence, 35 early and 18 late, and their clinicopathological characteristics and outcomes were compared. Of the 515 patients, the records for 307 patients who remained tumor free for at least 3 years after radical surgery were further examined. Results: No significant differences were found in clinicopathological characteristics and clinical outcomes between the early and late recurrence groups with regard to age, stage, histology, tumor size, lymphovascular space invasion, stromal invasion, parametrial involvement, node status, vaginal margin, preoperative blood testing, adjuvant therapy, symptom status at recurrence, site of recurrence and survival after recurrence. Late recurrence was detected in 18 of the 307 patients (5.9%). Only node status and deep stromal invasion (DSI) were independently associated with late recurrence. Conclusion: Lymph node metastasis and DSI are risk factors for late recurrence. Careful long-term follow-up is needed, particularly in cases with lymph node metastasis and/or DSI.

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