LATE SECOND CANCERS OF THE CERVIX AFTER APPARENTLY SUCCESSFUL INITIAL RADIATION THERAPY

1. Development of cancer of the cervix is described in 11 patients 15 to 39 years after apparent successful treatment of an initial cervix cancer by irradiation.

2. Most of these patients were in their twenties or thirties when the first cancer was treated by irradiation.

3. When the second cancer was detected, the duration of symptoms was brief (averaging 7 months), but the lesions were mostly extensive requiring pelvic exenterations in 7 of the 11 cases.

4. The long range salvage rate, all pelvic exenterations, was 3 among 11 and was for 15 years, 6 years and 3 years (the latter 2 still living and well). The surgical treatment mortality was 27 per cent, patients succumbing from sepsis after 45 and 90 days, respectively, and after 39 days from a cerebrovascular accident.

5. This series emphasizes the need for continued follow-up over years among patients, especially in the younger age groups, who have had apparent successful control of cervix cancer by irradiation, in order to detect and promptly treat second cancers (primary or recurrent) by appropriate and, if possible, less radical surgical procedures than would be called for in extensive lesions.

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