Oncological outcomes
In total 31 patients (13.7%) developed a recurrence of whom 28 patients (reflecting 12.4% of total cohort) developed the recurrence within five years of follow-up: 12 patients (19.7%) in group 1, eight patients (7.7%) in group 2, and eight patients (13.1%) in group 3. All three late recurrences occurred in group 1; compared to the previous analysis, one additional late recurrence (i.e. time interval of 14 years between diagnosis and recurrence) was observed. Ten patients in group 1 (10/15, 66.7%), eight patients in group 2 (8/8, 100%), and six patients in group 3 (6/8, 75.0%) presented with a locoregional recurrence of top of vagina, cervical tissue, pelvic side wall, and/or pelvic lymph nodes (with or without additional distant recurrence). The other patients presented with distant recurrence only. The 5-year DFS in group 1 and group 2 was similar to what was previously reported (slightly different because of the updated follow-up times): 80.3% in group 1 and 91.8% in group 2. In the newly added group 3, the 5-year DFS was 86.4%.
In total 16 patients died due to the sequelae of cervical cancer: nine patients (14.8%) in group 1, three patients (2.9%) in group 2 and four patients (6.6%) in group 3. Compared to the previous analysis, two additional patients died of disease within five years of follow-up in group 2, leading to the following 5-year DSS rates: 84.8% in group 1, 96.5% in group 2 and 92.9% in group 3. Two patients in this cohort died of other cases, both in group 2, leading to the following 5-year OS rates: 84.8% in group 1, 94.3% in group 2, and 92.9% in group 3.Figure 3 shows the Kaplan-Meier curves of 5-year DFS, 5-year DSS and 5-year OS of the three groups altogether.
When the newly added group 3 was compared to group 1, no significant differences existed in either the 5-year DFS (p =0.36), 5-year DSS or 5-year OS (p =0.22). Also, when group 3 was compared to the experienced phase, group 2, no significant differences existed in either the 5-year DFS (p =0.25), 5-year DSS (p =0.15) or 5-year OS (p =0.37).

Discussion