Background: Cervical stump cancer is a rare disease, which is
subsequent to a previous subtotal hysterectomy. Among patients who underwent a
subtotal hysterectomy, approximately 1%–3% develop cervical stump cancer which
represents 3%–9% of all the cervical cancers. Methods: After
acquiring consent from our ethics committee, we recruited the subjects and
reviewed the patients’ data of those who were admitted to our hospital from
January 2010 to December 2022. Written informed consent from all the study
participants was acquired, and all materials complied with the Declaration of
Helsinki and ethical standards. The patients’ data records, including clinical
characteristics, treatment methods, human
papillomavirus (HPV) infection conditions before the operation, complications of
the treatment and follow-up status were analyzed. The HPV infection status was
detected by Tellgen systems (Tellgen Corporation, Shanghai, China). SPSS software (Version 22.0, IBM
Company, Armonk, NY, USA) was used for data analysis. Data is shown as mean
standard deviation. A two-side p value 0.05 was considered
to be significant. Results: There were 127 cases with cervical stump
cancer treated in our hospital during this period. The interval time between
subtotal hysterectomy and stump cancer was 130.7 months. Vaginal bleeding,
postcoital bleeding and pelvic pain were the main symptom. Seventy-two cases were
squamous cancer and adenocarcinoma occurred in 39 cases. All patients received
surgery or concurrent chemoradiotherapy. One hundred and ten cases were included
in the follow-up. The median observation time was 65 months. Vaginal bleeding,
gastrointestinal symptoms and vaginal contracture were the most common
complications. The median observation time was 65 months and the 5-year
disease-free rate for all patients was 51.8% with the 5-year overall survival
for all patients being 77.3%. Conclusions: Subtotal hysterectomy
results in a potential to develop cervical stump cancer. Cytological studies,
cervical biopsy and endocervical curettage should be considered before a subtotal
hysterectomy is performed. The patients should be well informed of the risk for
retaining the cervical stump and further cervical stump cancer screening is
mandatory.
