A comparison of symptomatology, physical examination, and vaginal cytology in the detection of recurrent cervical carcinoma after radical hysterectomy.

To evaluate our surveillance program for recurrent cervical carcinoma, we reviewed patients who underwent radical hysterectomy for International Federation of Gynecology and Obstetrics (FIGO) stages IB and IIA cervical cancer. The study group consisted of 203 women followed at Duke University Medical Center exclusively who had at least 2 years of regular surveillance. Thirty-one (15%) developed recurrence. For the detection of recurrent tumor, vaginal cytology had a sensitivity and specificity of 13 and 100%, pelvic or general physical examination 58 and 96%, and the presence of suspicious symptoms 71 and 95%, respectively. Ninety-four percent of all patients with recurrent tumor had at least one abnormal surveillance index. Three of 31 patients (10%) with recurrent tumor were treated successfully with secondary therapy. Two recurrences were detected by vaginal cytology exclusively. Even though vaginal cytology is not sensitive and may not be cost-effective, we conclude that it is the technique most likely to detect recurrent tumor while it is localized and potentially curable.