Objective: To evaluate the results of surgical treatment for central recurrence or persistent local lesion of uterine cervical carcinoma following full-dose radiotherapy.
Methods: Forty-seven patients were diagnosed having central recurrence or persistent local lesion of uterine cervical carcinoma following full-dose radiotherapy. The patients were treated surgically: extrafascial hysterectomy was performed in 37 cases, radical hysterectomy in 7, and modified radical hysterectomy in 3. Their clinicopathological features were retrospectively reviewed.
Results: Central recurrence or persistent local lesion was confirmed by pathology in 36 patients, while negative in 11. For patients receiving extrafascial hysterectomy, the median survival time and 5-year survival rate were 22 months and 40.4%, while for radical hysterectomy corresponding figures were 26 months and 40.0%. The mean operation time for the extrafascial hysterectomy and the radical or modified hysterectomy was 2.5 and 3.8 hours, respectively. The mean blood loss was 272.1 and 610.0 ml, respectively. The postoperative morbidity was 21.6% for extrafascial hysterectomy and 70.0% for radical or modified hysterectomy (P = 0.007).
Conclusion: For some patients with central recurrence or persistent local lesion of uterine cervical carcinoma following full-dose radiotherapy, surgical intervention may achieve long time survival. Extrafascial hysterectomy is a feasible and effective treatment for some selected patients.