[Audit of deaths due to cervical cancer in a health service of Santiago. A preliminary analysis]. / Auditoría de muertes por cáncer cérvico-uterino, servicio de salud metropolitano Sur-oriente, 1995. Análisis preliminar.

BACKGROUND: Despite the epidemiological importance and the surveillance programs to detect cervix uterine cancer in Chile, its mortality continues to be high. AIM: To perform an audit of all deaths due to cervix uterine cancer, that occurred in a health service of Santiago during 1995. MATERIAL AND METHODS: The clinical records and pathological studies of 46 women, whose death certificates indicated cervix uterine cancer as the cause of death, were audited. RESULTS: In six women, the audit revealed that the cause of death was not a cervix uterine cancer, and they were discarded from further analyses. The higher mortality rate (36/100,000) occurred in women over 64 years old, those living in the poorest community and with less Papanicolaou vaginal smears coverage (La Pintana). The evolution prior to diagnosis was registered in only four women and was of less than one year. Most women consulted in advanced stages of the disease and only 48% were subjected to some sort of treatment (surgery, radiotherapy or chemotherapy). Mean survival was 3 years and mean age at death was 55.5 years old. There was a great lack of clinical and epidemiological information. In only 13 women information about previous Pap smears was registered. CONCLUSIONS: Audit of deaths should be an important component of preventive programs for cervix uterine cancer, and the coverage of Pap smears should be improved.

Tratamiento del carcinoma cervicouterino: Evaluacion de una experiencia de 3 anos / Treatment of cervix uteri carcinoma: evaluation of a 3 years' experience

Se analizan 130 pacientes portadoras de un carcinoma cervicouterino tratadas en la Unidad de Oncologia Ginecologica, Servicio de Obstetricia y Ginecologia, Hospital Dr.Sotero del Rio, desde abril de 1978 a abril de 1981. Se estudia su distribucion por edad, por estadios y tipos histologicos. Se presenta un protocolo de tratamiento quirurgico para estadios Ib con lesiones de menos de 2 cms. de diametro, y, un protocolo de terapia combinada (R.T. + histerectomia total simple) en pacientes con estadio Ib con tumores mayores de 2 cms. de diametro (Ic), y tumores endofiticos ("barrel shape"). Se plantea la posibilidad de extender este ultimo tipo de terapia a estadios IIa y IIb con gran volumen tumoralcervical. Llama la atencion el alto porcentaje de lesion persistente en cuello (57%) en aquellos casos sometidos a cirugia post R.T. En estadios II el tratamiento es con radioterapia local y externa, y en los estadios III y IV, fundamentalmente con R.T. externa. La morbilidad quirurgica tanto en las pacientes con cirurgia exclusiva como en aquellas con terapia combinada, esta dentro de los rangos senalados en la literatura nacional y extranjera. Las curvas de sobrevida para todos los estadios en esta evaluacion a 3 anos tambien estan de acuerdo a las publicaciones senaladas