Article Text
Abstract
Objectives In Ethiopia, cervical cancer is the second common cancer and accounts for 17% of malignancies in females. Gynecologic Oncology Fellowship Training Program was launched at St. Paul’s Hospital Millennium Medical college(SPHMMC) in 2016, the program works in collaboration with the University of Minnesota, University of Michigan and German Society of Gynaecological Oncology. In 2017, the program joined the global oncology fellowship training under the International Gynecologic Cancer Society. This study is presented to show the impact of global partnership on surgical care delivery for patients with cervical cancer managed at SPHMMC.
Methods A hospital-based retrospective cross-sectional study was conducted. The period 9/2008- 8/2013, was selected as a pre-fellowship period and the period 1/2026–8/2018 was selected to determine the impact of fellowship training on service delivery. Data was collected from medical charts. The retrieval rate was 84.3%.
Results A total of 102(48%) were eligible for radical hysterectomy and pelvic lymphadenectomy. Patients with advanced disease were referred for chemo-radiation. The mean age was 48 ± 11 years with range of 28 - 88 years. Clinical stage included stage IB 60(62.8%) and IIA 25(30%). Eighteen patients(20.9%) received neoadjuvant chemotherapy(NACT). There were 2 bladder injuries and 4 ureteric injuries and no death reported during the hospital stay. The bivariate analyses showed taking NACT significantly decreases the rate of pelvic lymph node metastasis with a P value of 0.01.
Conclusions Implementation of gynecologic oncology fellowship training increased surgical management of cervical cancer in Ethiopia. Quality improvement projects and cancer registry are needed to advance cervical cancer service delivery.