Therapeutic implications of patterns of recurrence in cancer of the uterine cervix.

Five hundred twenty-six patients with invasive cervical cancer, treated at the University of Kentucky from 1964 to 1976, were followed 2--12 years after therapy. One hundred and sixty patients (31%) developed tumor recurrence. Recurrent cancer was noted with 1 year after therapy in 58% of patients and within 2 years of treatment in 76% of patients. Only 6% of patients with recurrent cervical cancer survived 3 or more years. Stage of disease, cell type, lesion size, and the presence of lymph vascular space invasion by tumor cells were all shown to be prognostically significant. The addition of extrafascial hysterectomy to radiation therapy significantly decreased the incidence of recurrence in stage IB cervical tumors 5 cm or more in diameter. Analysis of this data suggests that radical hysterectomy and pelvic lymphadenectomy is as effective as irradiation only in the treatment of large cell squamous carcinomas 2 cm or less in diameter.