Selection of surgical therapy for lymph node recurrence within the radiation field after radiotherapy for cervical cancer; A review of 5 cases

Abstract

Synopsis: In the treatment of cervical cancer, there are many opportunities to choose radiotherapy as primary treatment or adjuvant therapy to surgery. Therefore, when cervical cancer recurs, whether the recurrence site is inside or outside of the irradiation field is important for treatment selection and prognosis. Recurrence within the radiation field cannot be re-irradiated to the same site realistically. Therefore, re-irradiation for recurrence within the irradiation field is limited due to complications, and other effective treatments are limited, resulting in short survival times. Chemotherapy and molecular-targeted drugs are the main treatments for recurrence. As a limited surgical therapy, although pelvic exenteration is guaranteed to be curative to some extent, it is only applicable to very limited cases in terms of invasiveness to the patient and loss of function. We performed a surgical intervention aimed at excision of the tumor for lymph node recurrence within the radiation field of cervical cancer. We report 5 cases in which the invasiveness to the patient was reduced and good results were obtained.Key words: uterine cervix, cytoreduction, cervical cancer, previously irradiated field, recurrence