title: Diagnostic, therapeutic and evolutionary characteristics of cervical cancer in Department of Radiotherapy, Mohamed V Military Hospital - Rabat in Morocco.
abstract: BACKGROUND
  Cancer of uterine cervix is the second most common cause of cancer related deaths among women. The aim of this study is to report the experience of Military Hospital Mohamed V in the management of cervical cancer and their results.
  
  
  METHODS
  All cervical cancer managed at the radiotherapy department of Military Hospital Mohamed V between January 2005 and February 2010, were included for investigation of their demographic, histological, therapeutic and follow-up characteristics. Of the 162 cases managed, 151 (93.2 %) cases were treated in our department.
  
  
  RESULTS
  In our study the median age was 51.5 years (33-82). The median duration of symptoms before diagnosis was four [3, 7] months. The major presenting complaints were abnormal vaginal bleeding (89.8 %). Squamous cell carcinoma cervix was seen in 86.2 % (n = 137), adenocarcinoma in 11.3 % (n = 18) and adenosquamous carcinoma in 2.4 % (n = 4). One hundred seventeen (84.8 %) cases were seen at late stage. An abdominal and pelvic computed tomography (CT) scan was performed in 34.6 % (n = 56) of cases, magnetic resonance imaging (MRI) in 62.9 % (n = 102). The pelvic lymph nodes were achieved in 16.6 % of cases. Over half of patients 58.3 % (n = 88) were treated with a combination of external beam radiation therapy (EBRT) and a concurrent cisplatin based chemotherapy (40 mg /m2 weekly). With a mean of 51.6 months (2 to 109), we recorded 19 (12.6 %) pelvic relapse and 15 (9.9 %) metastases. The median time to onset was 19.4 months (2-84 months). The local control rate was 63.6 % (n = 96) and 21 (13.9 %) patients were lost to follow-up. The overall survival (OS) at 3 years and 5 years was respectively 78.3 % and 73.6 % and the relapse-free survival (RFS) was respectively 80 % and 77.2 %.
  
  
  CONCLUSIONS
  Most of cervical cancer patients in Morocco are seen at late stage necessitating referral for radiotherapy, chemotherapy or palliative care. This may reflect lack of cervical screening in order to early detect and treat pre-malignant disease stage.
authors.affiliation: Department of Radiotherapy, Mohamed V Military Hospital, Rabat, Morocco.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Elmarjany
authors.affiliation: National Institute of Oncology, Rabat, Morocco.
authors.forename: Abdelhak
authors.initials: A
authors.lastname: Maghous
authors.affiliation: Department of Public Health, Laboratory of Biostatics, Clinical Research and Epidemiology, School of Medicine and Pharmacy of Rabat, Rabat, Morocco.
authors.forename: Rachid
authors.initials: R
authors.lastname: Razine
authors.affiliation: National Institute of Oncology, Rabat, Morocco.
authors.forename: Elamin
authors.initials: E
authors.lastname: Marnouche
authors.affiliation: Department of Radiotherapy, Mohamed V Military Hospital, Rabat, Morocco.
authors.forename: Khalid
authors.initials: K
authors.lastname: Andaloussi
authors.affiliation: Department of Radiotherapy, Mohamed V Military Hospital, Rabat, Morocco.
authors.forename: Amine
authors.initials: A
authors.lastname: Bazine
authors.affiliation: Department of Radiotherapy, Mohamed V Military Hospital, Rabat, Morocco.
authors.forename: Issam
authors.initials: I
authors.lastname: Lalya
authors.affiliation: Department of Radiotherapy, Mohamed V Military Hospital, Rabat, Morocco.
authors.forename: Noha
authors.initials: N
authors.lastname: Zaghba
authors.affiliation: Department of Radiotherapy, Mohamed V Military Hospital, Rabat, Morocco.
authors.forename: Khalid
authors.initials: K
authors.lastname: Hadadi
authors.affiliation: Department of Radiotherapy, Mohamed V Military Hospital, Rabat, Morocco.
authors.forename: Hassan
authors.initials: H
authors.lastname: Sifat
authors.affiliation: Department of Gynecology, Mohamed V Military Hospital, Rabat, Morocco.
authors.forename: Baba
authors.initials: B
authors.lastname: Habib
authors.affiliation: Department of Gynecology, Mohamed V Military Hospital, Rabat, Morocco.
authors.forename: Jaouad
authors.initials: J
authors.lastname: Kouach
authors.affiliation: Department of Radiotherapy, Mohamed V Military Hospital, Rabat, Morocco.
authors.forename: Hamid
authors.initials: H
authors.lastname: Mansouri
keywords: Cancer of uterine cervix; Concomitant radio-chemotherapy; Radiotherapy