Background

The prognosis of patients with recurrence of uterine cervical cancer after definitive radiotherapy and the efficacy of local salvage therapy for recurrence were evaluated.

Methods

We retrospectively reviewed 110 patients who were treated with definitive radiotherapy/chemoradiotherapy for uterine cervical cancer between 2008 and 2017 at our institution. Local salvage therapy was defined as any surgery or radiotherapy described in the medical record as intended for local control or cure.

Results

We identified 25 patients who developed recurrence after definitive radiotherapy/chemoradiotherapy. The median follow-up time post-recurrence was 18.9 months. Thirteen patients (52%) reported recurrence in the isolated extra-pelvic lymph node (EPLN). The 2-year overall survival after first recurrence (OSr) for patients with isolated EPLN recurrence was 83.1%, compared to that of 31.2% for patients with other patterns of recurrence (p < 0.001). The 2-year OSr for patients who underwent local salvage therapy was 75.2%, whereas that for patients who did not undergo therapy was 41.6% (p = 0.04). Among patients who had recurrence in the isolated EPLN and received local salvage therapy, 20% of the patients reported recurrence in visceral and/or bone metastases after local salvage therapy, and 50% of the patients experienced another EPLN recurrence, which was salvaged with repeating local therapy.

Conclusions

Patients with uterine cervical cancer with isolated EPLN recurrence had favorable prognoses. The indications of local salvage therapy should be considered, especially for patients with isolated EPLN recurrence.

中文翻译：

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宫颈癌根治性放疗后复发性宫颈癌局部挽救治疗的疗效

背景

评价宫颈癌根治性放疗后复发患者的预后及局部挽救治疗复发的疗效。

方法

我们回顾性分析了 2008 年至 2017 年在我们机构接受了宫颈癌根治性放疗/放化疗的 110 名患者。局部挽救治疗被定义为医疗记录中描述的用于局部控制或治愈的任何手术或放疗。

结果

我们确定了 25 名在根治性放疗/放化疗后出现复发的患者。复发后的中位随访时间为 18.9 个月。13 名患者 (52%) 报告孤立的盆腔外淋巴结 (EPLN) 复发。孤立性 EPLN 复发患者的首次复发 (OSr) 后 2 年总生存率为 83.1%，而其他复发模式的患者为 31.2% ( p  < 0.001)。接受局部挽救治疗的患者的 2 年 OSr 为 75.2%，而未接受治疗的患者的 2 年 OSr 为 41.6%（p = 0.04）。在孤立的 EPLN 复发并接受局部挽救治疗的患者中，20% 的患者报告局部挽救治疗后内脏和/或骨转移复发，50% 的患者再次出现 EPLN 复发，通过重复局部治疗。

结论

具有孤立性 EPLN 复发的子宫颈癌患者预后良好。应考虑局部挽救治疗的适应症，特别是对于孤立性 EPLN 复发的患者。