Survival rate and prognostic factors in advanced cervical cancer patients accompanied by renal impairment.

The objective of this study was to obtain information on the survival rate of advanced cervical cancer patients with renal impairment (ACCRI) and its prognostic factors. In addition, it is hoped that by this method the scoring system for predicting the death of ACCRI patients hopetully could be obtained. Design of the study used was retrospective cohort study. Data collected were retrieved from medical records of ACCRI patients from 1 January 1998 to 31 December 2003 at Dr. Cipto Mangunkusumo National Central General Hospital, Jakarta, with a total sample of 70 cases. The results of the study showed that mean survival of all ACCRI patients was 8.2 months, mean survival at sixth month was 39%, and mean survival at one year was 3.2%. Median survival was 5.3 months. Prognostic factors affecting the survival of ACCRI patients included histopathological type (adenosquamous cell and cell differentiation), cortical thickness of the kidney less than 1 cm, and nephrostomy.

Clinical-pathologic factors, as predictor of lymph nodes metastasis in cervical cancer stage IB and IIA.

The aim of this study was to identify possible predictor factors of lymph node metastases in patients with cervical cancer stage IB and IIA. Study was conducted between May 1996 and December 2001. There were 183 patients of cervical cancer with FIGO Stage IB and IIA who were underwent radical hysterectomy and lymphadenectomy. From those 158 patients could be evaluated, consisting 43 patients with node metastases 115 patients without metastases. Research design was case control study. Case was patients with node metastases and control was those without node metastases. Multivariate analysis was made after bivariate analysis. On bivariate analysis age < 39 years, diameter of lesion > 4 cm, stage IIA > 4 cm, histopathology moderate and poor differentiation, blood and lymphatic vessel invasion were independent variables for node metastases with p value ≤ 0.05. However, on multivariate analysis younger age, parity ≥ 4, diameter of lesion, histopathology adenosquamous, and lymph vascular invasion (+) as independent factors for node metastases with p value ≤ 0.05. Conclusion: Younger age, parity ≥ 4, stage IIA > 4 cm, diameter of lesion, histopathology adenosquamous, and lymph vascular invasion (+) were risk factors for node metastases and can be used as predictors.

An analysis on the delay of cervical cancer patients in seeking medical check up in Dr. Cipto Mangunkusumo National Central General Hospital Jakarta.

In Indonesia, most cervical cancer patients seek medical help after the cancer has reached advanced stage (62 %). This has caused cervical cancer to contribute to 66 % of gynecological deaths.1 The objective of this study is to find out factors related to the delay of cervical cancer patients in seeking for medical help. This research employs quantitative and qualitative methods. Samples were obtained from all of the new cervical cancer patients who came for the first time between 2000 to 2001 and returned to the Dr. Cipto Mangunkusumo National Central General Hospital Jakarta from August until October 2001. It is concluded that variables significantly correlated with the delay for medical check up are knowledge, attitude, the availability of Pap smear service and husband support. The availability of Pap smear plays as dominant variabel.

The histopathological predictor factors in the recurrence of cervical carcinoma stage IB - IIA after radical hysterectomy.

The aim of this study is to know the incidence of cervical carcinoma stage IB - IIA recurrence after radical hysterectomy and the histopathologic factors which are related to it. This was a retrospective cohort study involving 68 patients with recurrence cervical carcinoma stage IB - IIA who underwent radical hysterectomy, However, there were only 58 cases which fulfilled the study citeria, and therefore were evaluated histopathologically. The histopathologic evaluation consisted of differentiation, inflammatory reaction, lymph-vascular permeation, invasion to the vagina incision margin, and to endometrium, lymph nodes metastasis, and the depth of stromal invasion. The incidence of the cervical carcinoma stage IB-IIA recurrence 2 years after radical hysterectomy was 30.8% (21 out of 68 cases). The recurrence occurred in nine (75%) out of 12 cases with lymph node metastasis, compared to 10 (21.7%) out of 46 cases without lymph node metastasis (P = 0.0004). In addition, eight out of 11 adenosquamous carcinoma cases had recurrence (p = 0.01). There was only one out of the 12 cases with the depth of stromal invasion of < 5 mm that had recurrence compared to 18 out of 45 cases with stromal invasion of > 5 mm (P = 0.02). The clinical factors such as parity, staging, size of the tumor were not statistically significant. The other pathologic factors such as differentiation, inflammatory reaction, and parametrial, vagina incision margin and endometrial invasion were not statistically signifcant. The incidence of the recurrence of cervical carcinoma within 2 years after hysterectomy was related to the pathological risk factors i.e. lymph node metastasis, adenosquamous cell carcinoma and the depth of stromal invasion.