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

ABSTRACT

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