Highlights on recurrence after surgery for cervical cancer

ObjectiveAfter surgery due to cervical cancer women are offered to attend a follow-up program 10 times during five years with the purpose for early diagnosis of recurrence. The aim of this study is to evaluate the follow-up program, which has remained unchanged for 20 years even though reminding and concerning women, who we consider healthy after surgery.MethodsA retrospective longitudinal study of women attending follow-up program after surgery due to cervical cancer at the Department of Gynecology and Obstetrics, Aarhus University Hospital. 524 patients were identified from 1996 to 2011 with the diagnosis of cervical cancer combined with a surgical procedure. From the national pathological database and patient files information was extracted. Information was stored in Epidata. Associations were calculated using stratified analysis and logistic regression.Results133(25%) women of 524 needed further treatment. 45(12%) women of 391 treated by surgery had recurrence. Symptoms of recurrence and non-regional recurrence were negatively associated with survival. Diagnosis of recurrence at a scheduled control was positively associated with survival. Only 4(9.5%) cases of recurrence were diagnosed by PAP-smear.ConclusionsEvaluation on the follow-up program is valuable and might inspire to adjustments. By tradition a gynecological examination is processed along with a cytological test from the top of the vagina and a vaginal exploration. The results imply failing success in diagnosing recurrence by cytological test and a tendency for poorer outcome for patients debuting with symptoms in between scheduled follow-up visits.