Post-treatment surveillance and management of recurrent cervical cancer - A review from the french cervical cancer guidelines group
Year: 2026
Type: review
Abstract: OBJECTIVE: To review the available evidence on post-treatment follow-up and recurrence management after cervical cancer. METHODS: We conducted a narrative review of the literature on surveillance modalities, and the management of pelvic and nodal recurrences. RESULTS: Most recurrences occur within three years of treatment, but the survival benefit of detection before symptom onset remains unproven. After fertility-sparing surgery, HPV testing is sensitive for detecting asymptomatic pelvic recurrence. After hysterectomy, most recurrences are symptomatic, and clinical examination has a higher diagnostic yield than HPV testing or vaginal vault cytology. After concurrent chemoradiotherapy (CRT), persistent HPV infection is associated with an increased recurrence risk, but its limited specificity and the absence of a validated HPV-based surveillance strategy restrict its clinical utility. MRI and FDG PET/CT are useful for response assessment and investigation of suspected recurrence, but evidence supporting routine imaging of asymptomatic patients is lacking. Intensive follow-up schedules have not improved recurrence detection or survival. Evidence on recurrence management is predominantly retrospective. Pelvic recurrences after primary surgery have been treated with CRT, supplemented by brachytherapy for vaginal involvement. In selected patients with central pelvic recurrence after CRT, complete surgical resection may provide prolonged survival, but carries substantial morbidity. Nodal recurrences outside previously irradiated fields have been treated with CRT. CONCLUSION: Available evidence supports a predominantly clinical, treatment-adapted follow-up. The survival benefit of intensive surveillance, routine imaging, or detecting asymptomatic recurrence remains uncertain. Recurrence management requires individualized multidisciplinary assessment based on disease extent, disease-free interval, and previous treatments.
Authors: Aurélie Buffeteau, Pauline Chauvet, Abel Cordoba, Jean Levêque, Pascal Rousset, Isabelle Thomassin, Xavier Carcopino, Jean-Luc Brun, Xavier Carcopino, Lobna Ouldamer, Cyrille Huchon, Pauline Asseeva, Henri Azaïs, Sofiane Bendifallah, Jean-Luc Brun, Geoffroy Canlorbe, Cyrus Chargari, Pauline Chauvet, Abel Cordoba, Hélène Courcier, Yohann Dabi, Marion de Berti, Caroline Diguisto, Eva Fuss, Thomas Gaillard, Tristan Gauthier, Witold Gertych, Laurence Gladieff, Olivier Graesslin, Yohan Kerbage, Martin Koskas, Enora Laas, Aymeline Lacorre, Vincent Lavoué, Lise Lecointre, Fabrice Lecuru, François Margueritte, Alejandra Martinez, Paul-Jean Maternowski, Patrice Mathevet, Imane Menouer, Camille Mimoun, Anthony Moureau, Antoine Netter, Charles-André Philip, Pascal Rousset, Claire Sanson, Isabelle Thomassin-Naggara, Cyril Touboul, Jean Levêque
Institutions: Centre National de la Recherche Scientifique, Université de Bordeaux, Centre Hospitalier Universitaire de Bordeaux, Immunology from Concept and Experiments to Translation, Hôpital Pellegrin, Institut Pascal, Université Clermont Auvergne, Sigma Clermont, Centre Oscar Lambret, Inserm, Institut de Recherche en Santé, Environnement et Travail, Université de Rennes, Lyon 1 Université, Hospices Civils de Lyon, Hôpital Lyon Sud, Centre pour l'innovation en cancérologie de Lyon, Sorbonne Université, Assistance Publique – Hôpitaux de Paris, Hôpital Tenon, Aix-Marseille Université, Assistance Publique Hôpitaux de Marseille, Hôpital Nord, Centre d’Etudes et de Recherche sur les Services de Santé et la Qualité de Vie, Laboratoire de Microbiologie Fondamentale et Pathogénicité, Centre Hospitalier Universitaire de Tours, Université Paris Cité, Hôpital Européen Georges-Pompidou, Hôpital américain de paris, Pitié-Salpêtrière Hospital, Centre de Recherche Saint-Antoine, Hôpital Bichat-Claude-Bernard, Hôpital d'Hautepierre, Institut Curie, Centre Hospitalier Universitaire de Limoges, Institut universitaire du cancer de Toulouse Oncopole, Centre Hospitalier Universitaire de Reims, Université de Reims Champagne-Ardenne, Université de Lille, Centre Hospitalier Universitaire de Lille, Centre Hospitalier Universitaire de Rennes, Université Toulouse III - Paul Sabatier, Centre Hospitalier Universitaire Vaudois, Université de Toulouse, University of Lausanne, Université de Tours, Hôpital Lariboisière
Language: English
Subfield: Obstetrics and Gynecology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,360
OpenAlex ID: W7224458702