Management of recurrent cervical cancer: the place of ultra-radical surgery.

ABSTRACT

Although mortality from cervical cancer has decreased substantially the incidence of recurrent disease, at 35-50%, remains unaltered. Many more young patients are seen with recurrent cervical cancer today. This paper reviews this problem--its diagnosis and available modes of treatment. The place of re-irradiation, chemotherapy and ultra-radical surgery are discussed and their limitations highlighted. Better patient selection and individualised treatment planning are emphasised. Newer, more objective prognostic indicators based on molecular understanding of cancer cells are mentioned as hopeful means through which patient selection and treatment could be improved in the future. In the developing world where persistent or recurrent disease is more common, the situation is unlikely to improve soon.