Objectives: The purpose of this study was to evaluate the patterns of recurrence and its associated factorsin stage IB1-IIA cervical cancer cases after radical hysterectomy. Methods: We retrospectively reviewed the655 medical records of patients with cervical cancer who underwent radical surgery at Chiang Mai UniversityHospital between January 2003 and December 2006. All patients had a type III radical hysterectomy andcomplete systematic bilateral pelvic lymphadenectomy. Post-operative adjuvant pelvic radiation therapy wasgiven concurrently with weekly cisplatin 40 mg/m2 for 6 cycles to patients with at least one major risk or twointermediate-risk factors. Sites of disease recurrence, time to relapse of disease, and postoperative overall survivalwere analyzed and all possible clinicopathological factors related to the risk of recurrence were determined. Results: The median time to recurrence was 11.5 months (range, 2-45 months). There was no significantdifferences in the mean time to recurrence between local and distant recurrence groups (14.6 ±3.9 months vs.16.2±5.3 months; p=0.632). The 3-year survival rates of patients with local and distant recurrences were 67.6%(95%CI=45.6 to 89.6%) and 39.8% (95%CI=11.8 to 67.8%), respectively (p=0.602). Tumor size was the onlyclinicopathological prognostic factor associated with overall survival. Conclusion: Patients with stage IB1-IIAcervical cancer should have close surveillance during the first two years of radical surgery. Tumor size of greaterthan 2 cm at the time of primary surgery appears to be significantly related to the prognosis of patients withrecurrence. With an understanding of the natural history of cervical cancer recurrence, an optimal methodof follow-up and prospective clinical trial for markers of metastatic potential to detect recurrence need to beconducted in the future.
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