Radical hysterectomy as surgical salvage therapy for gynecologic malignancy

Fourteen patients with recurrent or second primary gynecologic malignancies after pelvic irradiation underwent radical hysterectomy as surgical salvage therapy. Six patients had microscopic regional metastatic disease at the time of surgery. All of these patients died of recurrent tumor. Overall disease-free actuarial survival at five years was 27%; excluding patients with regional metastatic disease, five-year survival was 54%. Complications requiring subsequent major surgical intervention occurred in 29% of patients. There appears to be a limited role for radical hysterectomy as surgical salvage therapy in patients with centrally limited invasive disease after pelvic irradiation.