Cervicovaginal cytology in the posttreatment surveillance of women with cervical cancer

Objective. Our aim in this study was to determine the value of cervicovaginal cytology in surveillance for recurrent cervical cancer. Materials and Methods. Charts were reviewed for 136 women with cervical cancer presenting at least 3 months after treatment with curative intent for a previously scheduled surveillance visit to Cook County Hospital between September 1, 1994, and December 31, 1995. Results of cytology and symptoms elicited by history and physical examination were compared to recurrences occurring within 6 months. Results. Recurrences were identified in eight patients. Sites of recurrence included cervix-vaginal cuff (n = 5), pelvic wall (n = 1), and paraaortic or supraclavicular lymph nodes (n = 2). Sixteen women had symptoms, and seven had abnormal physical findings. One woman had malignant cytology. Sensitivity, specificity, and positive and negative predictive value were 38, 90, 23, and 96%, respectively, for symptoms; 50, 99, 80, and 97%, respectively, for examination; and 13, 100, 100, and 95%, respectively, for cytology. Conclusion. After cervical cancer treatment, cervicovaginal cytology was a more specific but less sensitive predictor of recurrence within 6 months than were symptoms or physical findings.