Pelvic recurrence of cervical cancer. Analysis of 49 surgically treated patients.

Background: Pelvic recurrence of cervical cancer is a life-threatening event for patients. The main therapeutic challenge is to locally control such relapses. We present our experience of the surgical treatment of pelvic cervical cancer relapses. Patients and methods: From July 1980 to January 1994, 49 patients underwent a surgical procedure for pelvic cervical cancer relapse. Forty four tumor relapses were localized in the pelvis and 5 were associated with distant metastases. Surgery was performed alone in 31 cases and in association with radiotherapy in 18 cases. Median follow-up was 34 months. Results: The treatment was curative in 49% of cases. There was a significant correlation between the initial stage, the site of tumor relapse and surgical curability. Overall actuarial survival was 44% and 24% at 2 and 5 years, respectively. In the curative treatment group, actuarial survival was 71% and 47% at 2 and 5 years, respectively. There was a major surgical complication in 14 cases: 11 reoperations were performed. Thirteen patients are alive of whom 12 with no evidence of disease (median follow-up : 36 months). A local control was achieved in 53% of cases. Age and site of relapse significantly influenced survival. Conclusions: The results of this study are comparable with other surgical series despite our less favorable patient selection. For patients experiencing pelvic side-wall infiltration, surgical treatment is a worthwhile palliation in selected cases because it is often the only available therapeutic option.