Introduction/Background*Cervical cancer is the 4th most common cancer affecting females with 85% of cases occurring in developing countries. There is limited data available in the literature about locally advanced cervical cancer management outcomes from Egypt. This is the first and the largest study to describe locally advanced cervical cancer treatment outcomes from Cairo University National Cancer Institute (NCI), the largest tertiary center for cancer in Egypt.
Methodology A retrospective study was conducted including 160 patients with pathologically proven cervical cancer, locally advanced disease (FIGO stage IIB till IVA) who presented to gynecology group, Radiation Oncology Department, NCI from 2013 to 2017. Data were collected retrospectively from patients‘ medical records. Demographic, clinicopathological, treatment, and survival outcome data were retrieved. Survival analysis was estimated using the Kaplan-Meier method and compared using the log-rank test.
Result(s)*Data analysis showed a great disparity in management plans. Local control (LC) was achieved in 65.1% of the patients, and 31% had metastatic disease progression. Non-compliance to treatment was seen in 18.8% of the patients. Three years overall survival (OS) and five years OS were 45.6% and 35% respectively. Non-compliant patients had significantly lower 3 years OS (28.4%, P<0.001). The most common modality of treatment was concurrent chemoradiation therapy (CCRTH) followed by radical surgery. There was no significant difference in OS, LC, and time to the distant metastasis between the different treatment modalities.
Conclusion*Locally advanced cervical cancer management represents a challenging burden in developing countries like Egypt. Patient compliance was found to be the most important factor affecting survival in our population. Proper assessment of the factors causing low compliance should be properly evaluated. Strict follow-up and improving patient compliance are essential to achieve a favorable outcome.
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