RT Journal Article
SR Electronic
T1 Time course and outcome of central recurrence after radiation therapy for carcinoma of the cervix
JF International Journal of Gynecologic Cancer
JO Int J Gynecol Cancer
FD BMJ Publishing Group Ltd
SP 1106
OP 1111
DO 10.1136/ijgc-00009577-200605000-00025
VO 16
IS 3
A1 P. J. Eifel
A1 A. Jhingran
A1 J. Brown
A1 C. Levenback
A1 H. Thames
YR 2006
UL http://ijgc.bmj.com/content/16/3/1106.abstract
AB We investigated the time course of central disease recurrence (CDR) in 2997 patients treated with radiation for stage I–II squamous cell carcinoma of the cervix. CDR rates were 6.8%, 7.8%, and 9.6%, at 5, 10, and 20 years, respectively. The risk of CDR was independently correlated with tumor size (P < 0.0001) but not with FIGO stage. The hazard rate peaked in the first year of follow-up and then fell steeply; after 3 years, the hazard rate was approximately constant at 0.2–0.4% per year. Although after 3 years the risk of CDR was low, it continued to be slightly greater for patients with tumors ≥5 cm than for those with smaller tumors (P = 0.001). Patients who had CDR <36 months after treatment were less likely to be candidates for salvage therapy and had a poorer postrecurrence survival rate than those with recurrence ≥36 months after treatment (4.5% versus 42.1%, P < 0.0001). The higher rate of CDR in the first 3 years and the poor survival after early recurrence suggest that most early CDRs are true relapses. The relatively stable annual actuarial risk between 3 and 25 years and the better survival rate after late CDR suggest that most “recurrences” after 3 years are actually new neoplasms.