ABSTRACT
Generally, in patients with cervical cancer, careful preliminary evaluation is necessary for avoiding improper surgical procedures and making effective clinical decisions for treatment. The aim of this study was to determine surgeon errors, which necessitate a combination of surgery and radiotherapy for cervical cancer patients. In this retrospective study, medical records of all cervical cancer patients, undergoing hysterectomy at tumor clinics of Ghaem and Omid Hospitals, were collected from 1988 to 2008. In total, the medical records of 93 subjects with postoperative radiotherapy were examined. All records were assessed in terms of surgeons' errors, patients' follow-up after radiotherapy, rate of disease recurrence, and mortality rate. In addition, survival factors were recordedandassessed, and cumulative 3- and 5-year disease-free survival [DFS] rates as well as overall survival [OS] rate were determined by Kaplan-Meiertest. The overall rate of surgeons' errors was 41%. The most common surgical error was improper surgical care due to surgeon's lack of knowledge about the cervical cancer treatment. The 3-year DFS rates were 86% and 64% in cases without surgeon's error and those affected by surgeon's error, respectively. In addition, the 5-year DFS rate was 53% in the non-affected group and 47% in cases affected by surgeon's error [P=0.05]. Pre-treatment evaluation as well as proper treatment is necessary for the prevention of adverse effects, caused by inappropriate surgical interventions. It is suggested that more time and attention be allocated to the improvement of surgical outcomes
ABSTRACT
Carcinoma of the uterine cervix is a significant cause of mortality because of malignancy in women. Radiotherapy is a major treatment modality for invasive cervical cancer with good treatment outcome in early-stage patients. However, substantial treatment failures still occur in the advanced-stage patients. In this case report a long term follow up of a 58 years old woman with stage II cervical squamous cell carcinoma [SCC], who was considered inoperable due to her general condition, cardiac poor function and ischemic heart disease [IHD] has been reported. After full dose external radiotherapy the patient became disease free till 6 years and after local recurrence, she was treated successfully with total abdominal hysterectomy [TAH] and bilateralsalpingo-oophorectomy[BSO]as well as adjuvant chemotherapy with favorable results during a long term follow up of 14 years. It is concluded that long term favorable outcome may be achieved by intensive radiotherapy of uterine cervix SCC and probable recurrence could be managed successfully by surgical excision