Late recurrence of locally advanced cervical cancer treated with concurrent chemoradiotherapy

Abstract

Introduction. This study aimed to compare clinicopathological factors between late-recurrence and early-recurrence patients (using late recurrence at ≥ 3 years and 5 years as cut-off points) in locally advanced cervical cancer (LACC) treated with concurrent chemoradiotherapy (CCRT). This study also identified independent risk factors for late recurrence. Material and methods. We analyzed data from LACC patients treated at Songklanagarind Hospital between 2002 and 2016, who had received definitive CCRT. A total of 1231 patients were retrospectively reviewed. Results. The median follow-up was 4.6 years, and the total recurrence rate was 28.7% (353 of 1231 patients). The late recurrence rates were 7.4% and 2.2% for ≥ 3 and 5 years after CCRT, respectively. When comparing the risk factors of late recurrence at ≥ 3 years with early recurrence, we found that anemia and thrombocytosis were found less frequently in late recurrence (26.2% vs . 46.9% and 9.8% vs . 23.6%, respectively). At ≥ 5 years, no differences in risk factors between the recurrent groups were found. When including only patients that remained tumor-free after 3 years, stage III–IVA was the only independent risk factor associated with late recurrence at ≥ 3 years (p = 0.042). Univariate analysis showed no significant associated factor for late recurrence after 5 years. Conclusions. Late recurrence at ≥ 3 years was not rare. Even though we could not find any significant association between clinicopathologic factors and late recurrence after 5 years, 2.2% of patients still had late recurrence. Long-term follow-up should be considered, especially for more advanced stages (stage III–IVA).