Results of Invasive Cervical Cancer Treatment at BMA Medical College and Vajira Hospital

Abstract Results of Invasive Cervical Cancer Treatment at BMA Medical College and Vajira Hospital Chantawat     Sheanakul               MD* Sumonmal     Manusirivithaya     MD* Thanathip      Tantiwattana           MD** Laddawan      Nakwong                  MD**   *Gynecologic Oncology Section, Department of Obstetrics and Gynecology, BMA Medical College and Vajira Hospital **Radiologic Oncology Section, Department of Radiology, BMA Medical College and Vajira Hospital Objective:  To study the clinical and pathological characteristics of invasive cervical cancer patients together with the prognostic factors and results of treatment in terms of overall 5- year survival rate. Study design:  Descriptive study. Subjects:  All 573 patients with pathological confirmation of invasive cervical cancer primarily were treated at BMA Medical College and Vajira Hospital between 1993-1998. Methods:  Medical records including out-patient records, in-patient records, gynecologic oncology registration records, radiation oncology records and pathological reports were retrospectively reviewed.  Patients' age, stage, histologic type, treatment and follow up information were recorded. Main outcome measures:  Overall 5-year survival rate. Results:  There were altogether 573 new cases of invasive cervical cancer treated at BMA Medical College and Vajira Hospital during the study period.  The mean age of the patients was 50.5+11.8 years.  Nearly 80% were squamous cell carcinoma, while the rest were adenocarcinoma of adenosquamous cell carcinoma.  Most of the patients (74.2%) were diagnosed in stage II or III, while stage I was diagnosed in only 16.6%  The overall 5-year survival rate for all stages was 61.5% (95% confidence interval of 57.0%, 66.1%).  The most important factor that correlated with survival rate was tumor stage.  Patients in stage I had higher survival rate than stage II, III and IV with the 5-year survival rate of 91.1%, 71.6%, 47.6%, and 20.6% respectively.  Adenocarcinoma tended to have lower survival rate comparing to squamous cell carcinoma, stag by stage but did not reach statistical significance. Conclusion:  Most cases of invasive cervical cancer were diagnosed in stage I or II and the frequent histologic cell type was squamous cell carcinoma.  The overall 5-year survival rate was 61.5%.  Tumor stage was the most significant prognostic factor. Key word:  cervical carcinoma, invasive, prognostic factors, 5- year survival rate Vajira Med J 2003 ; 47 : 93 - 102