The value of follow-up in FIGO Stage IB carcinoma of the uterine cervix

Abstract

The value of hospital follow-up in the detection of first locoregional or metastatic relapse was assessed in 276 patients with histologically confirmed FIGO Stage IB carcinoma of the cervix. All were treated by intracavitary and external beam irradiation. The maximum period of follow-up studied was 10 years (median follow-up was 55 months) during which 3190 routine and interval clinical visits were made. Fifteen (44%) of locoregional relapses (LRR) and eight (38%) of metastatic relapses were detected at routine visits (137 visits per relapse detected). Seventy-five per cent of relapses occurred within the first 5 years. Nine LRR occurred in the second quinquennium. Five (14.7%) of LRR underwent salvage surgery, three of whom were asymptomatic at the time of relapse. If routine visits had been stopped at 5 years the number of clinical visits would have been reduced by 15%, possibly at the cost of one patient whose asymptomatic LRR might not have been amenable to salvage surgery, had she not presented until she was symptomatic. Routine follow-up beyond 5 years is of dubious benefit in the detection of relapse.