Treatment Outcomes of Early Carcinoma Cervix Before and After Sub-specialization
- PDF / 437,158 Bytes
- 8 Pages / 595.276 x 790.866 pts Page_size
- 9 Downloads / 160 Views
ORIGINAL ARTICLE
Treatment Outcomes of Early Carcinoma Cervix Before and After Sub-specialization Vinotha Thomas 1 & Rachel G. Chandy 1 & Ajit Sebastian 1 Thomas S. Ram 2 & Abraham Peedicayil 1
&
Anitha Thomas 1
&
Dhanya S. Thomas 1
&
Received: 27 April 2020 / Accepted: 15 September 2020 # Indian Association of Surgical Oncology 2020
Abstract This study aimed to compare the treatment outcomes in carcinoma cervix before and after gynecologic oncology subspecialization at a tertiary care hospital, in India. This was a retrospective cohort study comparing women with operable cervical cancer who underwent radical hysterectomy before and after gynecologic oncology sub-specialization. Electronic medical records of women operated for early carcinoma cervix between 2001 and 2010 and 2011–2015 were reviewed and compared for treatment and oncological outcomes. Seventy-four patients were operated over 5 years after sub-specialization as against 59 over 10 years before sub-specialization, with similar clinical characteristics. After surgical-pathological examination, both cohorts were comparable with regard to mean tumor size, lymph nodes retrieved, deep stromal invasion, and involvement of lymph nodes, parametrium, and vaginal margins. After sub-specialization, the rate of intraoperative (3% versus 14%, p = 0.018) and postoperative complications (15% versus 46%, p < 0.001) was lower. Adjuvant radiation was used more after subspecialization (50% versus 24%, p < 0.001). The follow-up rates were similar in both groups with comparable 5-year recurrence-free survival and overall survival rates. The hazard ratio for death after sub-specialization was 0.39 (95% CI 0.12 to 1.22) after adjusting for histology, stage, grade, and presence of intermediate or high risk factors. Gynecological oncologic subspecialization decreased intraoperative and postoperative complications, improved pathological reporting, and enabled appropriate tailoring of adjuvant therapy. Keywords Carcinoma cervix . Radical hysterectomy, . Specialization
Introduction Cervical cancer is a major health problem in India in the absence of an organized screening program, with 96,922 new cases annually, contributing to 17% of the global burden of 569,847 annual cases [1]. In India, it causes more than 5% of the total cancer disability-adjusted life-years. The agestandardized incidence rates vary across the states of India Electronic supplementary material The online version of this article (https://doi.org/10.1007/s13193-020-01228-x) contains supplementary material, which is available to authorized users. * Abraham Peedicayil [email protected] 1
Department of Gynaecologic Oncology, Christian Medical College, Vellore 632004, India
2
Department of Radiation Oncology, Christian Medical College, Vellore, India
[2]. With an average age-standardized incidence rate of 14.6 per 100,000 women per year, it is the second most common cancer among women aged 15–44 years [3]. The median age of occurrence is 38 years (age 21–67 years) [4] with peak incidence of dise
Data Loading...
