Recurrent Stage IB cervical carcinoma: Evaluation of the effectiveness of routine follow up surveillance

Objective To study the effectiveness of follow up surveillance in detecting recurrent disease following radical hysterectomy for Stage IB cervical carcinoma. Design Retrospective analysis of clinical records using a computerised database. Participants Six hundred and seventy-four patients with Stage IB carcinoma of the cervix underwent radical hysterectomy and lymph node dissection. Interventions Standard follow up surveillance consisted of clinical history and physical examination six weeks post surgery, and subsequently three monthly for the first year, six monthly for the second year, and yearly thereafter until 10 years post-treatment. Results Of the 674 patients, 112 (17%) developed recurrent disease. in only 29/112 (26%) was recurrent disease detected at the time of routine follow up visits. Nearly half of the patients (44%) were referred by their general practitioner between visits to the clinic because of suspicion of recurrent disease. Conclusion Routine follow up surveillance is ineffective in detecting recurrent cervical carcinoma. Only one in four recurrences were detected at the time of a clinical visit.