Primary treatment of cervical carcinoma. Ten years experience from one Norwegian health region.
OBJECTIVE
To study the primary care of cervical carcinoma with regard to clinical and pathological factors, treatment decisions, complications and survival.


METHODS
A historical cohort comprising all women hospitalized with invasive cervical carcinoma (n=293) during the period 1987-1996.


RESULTS
Median age was 52 years (range 23-90). FIGO stage distribution was 62%, 15%, 18% and 5% in stages I, II, III and IV, respectively. Early stage disease correlated with young age. Histologic types were: squamous cell carcinoma 84%, adenocarcinoma 11%, adenosquamous carcinoma 4% and small cell/anaplastic carcinoma 1%. Primary therapies were: surgery 188 women (64%), radiotherapy 99 women (34%), chemotherapy two women (0.7%); four women not treated (1.3%). Complications after surgery in 25 women (13%), none were fatal. Acute or late complications after primary or postoperative radiotherapy in 39 women (25%), seven (4.6%) were late serious complications. Three women died from complications related to radiotherapy. Mean follow-up of surviving patients was 58 months. Overall disease specific five-year survival was 70%. Five-year survival in stages IA, IB, II and III was 100%, 88%, 58% and 20%, respectively. One-year survival in stage IV was 31%. Median survival in stages III and IV according to curative or palliative aim of treatment was 20 and 6 months, respectively (p<0.005).


CONCLUSIONS
Satisfactory quality of diagnosis and therapy have been maintained through regional care for cervical cancer patients.
Hagen
B
B
Department of Obstetrics & Gynecology, Trondheim University Hospital, Norway.
Skjeldestad
F E
FE
Halvorsen
T
T
Strickert
T
T
Tingulstad
S
S
Lorenz
E
E
Onsrud
M
M
D000230:Adenocarcinoma / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D011183:Postoperative Complications; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*