OBJECTIVES: To assess the survival of patients who have received an operation for recurrent cervical and endometrial cancer and to determine prognostic variables for improved oncologic outcome. METHODS: A retrospective multicenter analysis of the medical records of 518 patients with cervical (N = 288) or endometrial cancer (N = 230) who underwent surgery for disease recurrence and who had completed at least 1 year of follow-up. RESULTS: The median survival reached 57 months for patients with cervical cancer and 113 months for patients with endometrial cancer after surgical treatment of recurrence (p = 0.036). Histological sub-type had a significant impact on overall survival, with the best outcome in endometrial endometrioid cancer (121 months), followed by cervical squamous cell carcinoma, cervical adenocarcinoma, or other types of endometrial cancer (81 vs 35 vs 35 months; p <0.001). The site of recurrence did not significantly influence survival in cervical or in endometrial cancer. Cancer stage at first diagnosis, tumor grade, lymph node status at recurrence, progression-free interval after first diagnosis, and free resection margins were associated with improved overall survival on univariate analysis. On multivariate analysis, the stage at first diagnosis and resection margins were significant independent predictive parameters of an improved oncologic outcome. CONCLUSION: Long-term survival can be achieved via secondary cytoreductive surgery in selected patients with recurrent cervical and endometrial cancer. An excellent outcome is possible even if the recurrence site is located in the lymph nodes. The possibility of achieving complete resection should be the main criterion for patient selection.

1st Department of Oncologic Surgery Gynecologic Oncology Unit Regional Institute of Oncology Iasi Romania

1st Faculty of Medicine Charles University Prague and Hospital Na Bulovce Prague Prague Czech Republic

Département de Cancérologie Gynécologique Oscar Lambret Center Lille France

Department Obstetrics and Gynaecology Steve Biko Academic Hospital University of Pretoria Pretoria South Africa

Department of Gynecologic Oncology MD Anderson Cancer Center Madrid Spain

Department of Gynecologic Oncology National Cancer Institute Bratislava Slovakia

Department of Gynecological Oncology University Medical Center Utrecht Utrecht Netherlands

Department of Gynecology and Obstetrics Jagiellonian University Medical College Krakow Poland

Department of Gynecology Obstetrics and Urology Sapienza University of Rome Rome Italy

Department of Gynecology with Center for Oncological Surgery European Competence Center for Ovarian Cancer Campus Virchow Klinikum Medical University of Berlin Berlin Germany

Department of Obstetrics and Gynecology Clínica Universidad de Navarra Pamplona Spain

Department of Obstetrics and Gynecology Division of Gynecologic Oncology Cerrahpasa Medical School Istanbul University Istanbul Turkey

Department of Obstetrics and Gynecology Faculty Hospital Constantine the Philosopher University Nitra Slovakia

Department of Obstetrics and Gynecology Gynecologic Oncology Center 1st Faculty of Medicine Charles University Prague and General University Hospital Prague Prague Czech Republic

Department of Obstetrics and Gynecology Institute of Women'sLife Medical Science Yonsei University College of Medicine Seoul Republic of Korea

Division of Gynecologic Oncology Department of Obstetrics and Gynecology Baskent University Schoolof Medicine Ankara Turkey

Division of Gynecologic Oncology Department ofObstetrics and Gynecology Etlik Zubeyde Hanim Womens Health Research and Teaching Hospital Ankara Turkey

Division of Women's Health Federal University of Minas Gerais Belo Horizonte Brazil

Fondazione IRCCS IstitutoNazionale dei Tumori Milan Italy

Gynecologic Oncology La Paz University Hospital Madrid Spain

Institute for Biostatistics and Analyses Masaryk University Brno Czech Republic

St Elizabeth Cancer Institute Bratislava Slovak Republic

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