M322 Initial Experience of Radical Hysterectomy for Early Cervical Cancer in Nepal (original) (raw)
Related papers
Asian Pacific Journal of Cancer Prevention, 2015
Background: To evaluate the rate of pathologic high-risk factors, intermediate-risk factors, and treatment outcomes in early-stage cervical cancer patients undergoing radical hysterectomy and pelvic lymphadenectomy (RHPL). Materials and Methods: Medical records of stage IA-IIA1 cervical cancer patients who underwent RHPL during the 2006 to 2012 time period and patient follow-up data until December 2013 were reviewed. Results: Of 331 patients, 52 women (15.7%) had pathologic high-risk factors and 59 women (17.8%) had intermediate-risk factors without high-risk factors. All studied patients had an initial complete response. At median follow-up time of 40.9 months (range 1-103.3 months) and mean follow-up time of 43.3±25.3 months, 37 women had disease recurrence and 4 women had died of disease. The most common site of recurrence was the pelvis (64.8%). Fiveyear and 10-year disease free survival rates were 96.1% and 91.5%, respectively. Five-year and 10-year overall survival rates were 100% and 99.4%, respectively. Independent factors related to recurrence were pelvic node metastasis (odds ratio [OR], 2.670; 95%CI, 1.001-7.119), and >1/3 cervical stromal invasion (OR, 3.763; 95%CI, 1.483-9.549). Conclusions: The rates of pathologic high-risk and intermediate-risk factors should be considered and disclosed when counseling patients regarding primary treatment by RHPL. Oncologic outcomes of primary surgical treatment for early-stage cervical carcinoma were found to be excellent.
Berkala Kedokteran, 2021
Cervical cancer is a gynecologic disease that has a high level of malignancy and is a major cause of death from cancer in women. To be used as educational material for patients with cervical carcinoma when if there is known outcome of radical hysterectomy in patients with IB-IIA cervical carcinoma, it can be used as a basic data to know the success rate of radical hysterectomy.The sample was collected by consecutive sampling and we found a total of 55 IB-IIA cervical carcinoma patients who underwent a radical hysterectomy. The samples that met the inclusion criteria are 30 people. Data analysis using Chi-square/Fisher method (significant pvalue <0.05).In this study, 16.7% of patients with cervical carcinoma from IB to IIA died in 3 years after radical hysterectomy was performed. The average age of patients with stage IB to IIA cervical carcinoma was 48.03 ± 12.21 years with ages ranging from 23 to 78 years. Stage IIA is 16 times more significantly at risk for mortality in cervical carcinoma patients than stage IB. The 3-year survival rate for patients with stage IB to IIA cervical carcinoma after radical hysterectomy was 83.3% with an average life span of 32.8 months. Patients with stage IB to IIA cervical carcinoma after radical hysterectomy have an average disease-free interval (DFI) of 33.0 ± 5.74 months.
Postradical Hysterectomy Survival Rate in Early Stage Cervical Cancer Patients
Indonesian Journal of Obstetrics and Gynecology, 2017
Objective: Determining the survival rate of early stage cervical cancer patients after radical hysterectomy. Method: A retrospective cohort study was conducted on 24 earlystage cervical cancer patients who had performed radical hysterectomy in Prof. dr. R.D. Kandou Hospital Manado during the period between January 2008 and December 2010. We used Kaplan-Meier methods to observe the survival rate. Result: The mean age of patients in this study was 47.8 (33-63) years old with a median of 45 years old. The largest proportion was less than 50 years old (66.7%) and stage IIA cervical cancer (66.7%) as the severity of cancer. Most histopathology type was the squamous cell carcinoma (50.0%). About 70.8% patients did not have lymph nodes metastasis and 62.5% patients did not receive adjuvant therapy. This study revealed that 1-year, 2-year, 3-year, 4-year, and 5-year survival rate were 100.0%, 100.0%, 95.8%, 83.0%, 70.8%; respectively. Conclusion: The survival rate of early stage cervical ca...
Invasive cervical cancer treated initially by standard hysterectomy
Gynecologic Oncology, 1990
Ninety-two patients with invasive cervical cancer initially treated by standard hysterectomy were evaluated for features related to survival. The cell type included squamous cell (64) and adenocarcinoma (28). Posthysterectomy therapy included radiation therapy (78), pelvic lymphadenectomy , and radical parametrectomy (1). Hysterectomy was initially performed for the following indications: invasive lesion missed on cone biopsy, 17; hemorrhage at cone biopsy, 2; bleeding, 16; abnormal cytology, 13; presumed endometrial cancer, 9; known cancer, 7; pelvic relaxation, 5; planned therapy, 3; fibroids, 3; adnexal mass, 2; chronic discharge, 1; pyometra, 1; postpartum endometritis, 1. The cumulative S-year survival for all patients was 68%, for squamous cell 80%, and for adenocarcinoma 41% (P = 0.0001). On postoperative evaluation 84 patients had presumed Stage I and 7 had parametrial involvement (Stage II). Patients with Stage I disease were then examined separately by cell type. Fifty-seven patients with squamous cell disease had cumulative S-year survival of 85%. Radiation therapy in the immediate postoperative period produced a survival of 88%, compared to observation only with a 69% survival (P = .lO). Patients with squamous cell disease and more than 50% cervical invasion had a 75% survival compared to a 96% survival for those with less than 50% (P = .02). The presence of disease. at the surgical margins, grade, age, and increase in radiation therapy did not influence survival. Twenty seven patients with presumed Stage I adenocarcinoma had a cumulative S-year survival rate of 42%. Survival was significantly mfluenced by tumor grade (P = .018) and the amount of postoperative radiation therapy (P = .03), while age, amount of residual tumor, and presence of tumor at surgical margins did not influence survival. Patients with invasive squamous cell carcinoma treated by standard hysterectomy and postoperative radiation therapy have a prognosis similar to those treated initially by either radical surgery or radiation therapy. Patients with ad-' enocarcinoma appear to have a significantly decreased survival when compared to patients with squamous cell disease and their prognosis is related to tumor grade and the amount of postop erative pelvic radiation. 0 1990 AC&ICC press, h. 7
Surgical outcomes of patients with stage IA2 cervical cancer treated with radical hysterectomy
Asian Pacific journal of cancer prevention : APJCP, 2013
This study was undertaken to evaluate the surgical outcomes of patients with stage IA2 cervical cancer treated with radical hysterectomy. Data for 58 patients who underwent modified radical hysterectomy or radical hysterectomy with pelvic lymphadenectomy between January 2003 and December 2012 at Chiang Mai University Hospital were retrospectively reviewed. The analysis included clinico-pathological risk factors (nodal metastasis, parametrial involvement), adjuvant treatment, 5-year disease-free survival and 5-year overall survival. All pathologic slides were reviewed by a gynecologic pathologist. Follow-up methods included at least cervical cytology and colposcopy with directed biopsy if indicated. Univariate analysis was performed to identify factors associated with median survival. At the median follow up time of 73 months, the 5-year disease-free survival and the 5-year overall survival were 97.4% and 97.4%, respectively. Two (3.4%) patients had pelvic lymph node metastases. In a...
Journal of Indira Gandhi Institute of Medical Sciences, 2019
Non-communicable diseases form a major bulk of patients in our country and are now the target of policy makers in India. Cancer is a cause of significant morbidity and mortality and needs to be tackled aggressively. Female genital tract malignancies have a worldwide distribution, but the distribution and frequency vary from one region to another. The objective of this study is to determine the patterns and frequencies of female genital tract malignancies in our population. The current study is a retrospective analysis of all operated cases of gynaecological malignancies from January 2012 to December 2016 at a tertiary care centre in Bihar. Methodology Out of 264 cases operated, 150 cases (56.81%) were of ovarian cancer, 83 (31.44%) were of cervical cancer, 26 (9.84%) were of endometrial cancer, 3 (1.14%) were of vulvar cancer, 1 (0.38%) was of choriocarcinoma and 1 (0.38%) was of fallopian tube carcinoma. Results A total of 264 cases of gynaecological malignancies underwent surgery. Ovarian cancer was the most common (56.81%), followed by cervical cancer (31.44%). The age of occurrence of gynaecological malignancies ranged from 9 to 70 years, and the mean age of presentation was 44 years. Peak frequency is observed in the fifth decade of life. Serous cyst adenocarcinoma was the most common histopathological type in ovarian cancer, squamous cell carcinoma was the most common in cervical and vulvar cancers and endometrioid adenocarcinoma was the most common type in endometrial cancer. Many rare histopathological variants were noted in our study. Conclusion As ovarian cancer is tricky, is hard to spot and spreads faster than any other cancer in the female reproductive system, the awareness of risk factors and that of vague symptoms can lead to early detection. Cervical cancer is preventable. To bring down its incidence rate, the Indian government, like its Western counterparts, needs to implement strict screening guidelines and strengthen our primary health centres and community health centres with facilities for screening.
A scenario of cervical carcinoma in a cancer hospital
JNMA, Journal of the …, 2009
Introduction: Cervical carcinoma is an important women's health problem throughout the world. There are very few published data on this disease in Nepal. We wanted to study the pattern of cervical carcinoma based on hospital data. Methods: A 10 years retrospective study of scenario of cervical carcinoma was conducted. The data have been analyzed according to age, occurrence of other cancers, histological type, religion, risk factors and district wise. Results: The number of cervical carcinoma showed a rising pattern over the 10 year period. The median age of the patients was 45 years and maximum frequency (33%) of cases were found in the age group 40 to 49 years. Squamous cell carcinoma comprised 40% of cases, Adenocarcinoma 4% and 1.1% cases were of mixed variety. 92% of cases were Hindu by religion. 43% of patients were smoker in our study, 5% had positive family history. Chitwan with 7.35% had the maximum number of cases followed by Rupandehi with 6.40% and Nawalparasi with 5.41%. Conclusions: The cancer pattern revealed by the present study provides valuable leads to cervical cancer epidemiology in Nepal. Routine cytological screening of the population for cervical cancer is highly necessary for its early detection and treatment.
Managing cervical cancer in Nepal: Need of consensual guideline
Nepal Journal of Obstetrics and Gynaecology, 2010
The purpose of this review is to bridge the pattern of intervention in optimal and sub-optimal facility level.Several guidelines for the screening and treatment of cervical cancer are reviewed. Routine screening isfound grossly lacking and non existent outside major health institution. Only nominal data and interventionefforts found published. There are three prongs of intervention level namely prevention/screening, treatmentand palliation together. Pap smear test is the standard screening tool wherever the cyto-diagnostic facilityexists. Visual Inspection with Acetic acid and Lugol's Iodine will be the feasible alternative at low resourcesetting. Primary surgical treatment for early cervical cancer is the best option. Likewise chemo-radiation withor without surgery will be the alternative option. Need of at least an operational guideline in each institutionis realized at this moment as a recommendation.Key words: Cervical intraepithelial neoplasia (CIN); colposcopy; Pap smear (...
Radical hysterectomy for stage IIB cervical cancer: a review
International Journal of Gynecological Cancer, 2005
Patients with stage IIB cervical cancer in some countries in Europe and Asia especially in Japan are usually treated with radical hysterectomy and pelvic lymphadenectomy. Extrauterine diseases, ie, nodal metastases, parametrial invasion, and intraperitoneal spread, can be readily identified. We present the literature review of radical hysterectomy in stage IIB cervical cancer by searching data since 1980 from Medline, and we found that the parametrial involvement of patients in this stage was only 21-55%, the incidence of pelvic node metastases was about 35-45%, and 5-year survival rate was between 55% and 77%. Lymph node metastases and the number of positive nodes were significant prognostic factors of patients in this stage.
Chinese journal of cancer research = Chung-kuo yen cheng yen chiu, 2016
The radical hysterectomy (RH) surgical technique has improved along the years. It is used for the treatment of cervical cancer, endometrial cancer when affecting the cervix, and upper vaginal carcinomas. Our aim was to describe the historical evolution of the technique after the introduction of laparoscopy at our institution. We performed a retrospective review of medical records of patients who underwent RH, grouped in three periods according to the year of surgery: 1990-1999, 2000-2009 and 2010-2013. Patients?characteristics, pathologic details, intraoperative and postoperative complications were analyzed and compared throughout the time periods. A total of 102 cases of RH were performed at our center during the study period. Among all data collected, the presence of necrosis, age, number of lymph nodes, surgery route, operating time, hospital stay, blood loss and transfusion requirement were statistically significant different among groups. Conversion to laparotomy rate was 19% f...