Primarily Surgical Treatment of Cervical Cancers Diagnosed in Stages IA–IIA at Can Tho Oncology Hospital: An Overview of 9 Years’ Experience 2000–2008

Abstract

Aims This study aims to evaluate the diagnosis, treatment, and outcomes of early stages cervical cancers. Materials and methods: a Randomized descriptive survey of 146 cases/786 cervical cancer patients hospitalized, classified into early stages (IA–IIA) and primarily treated in surgery at Can Tho Oncology Hospital from 06/2000 to 6/2008. Result Predominant age of patients was from 40 to 59 year old (85%); mean age were 49 yo; the youngest were 23 yo; the oldest was 75 yo. Postmenopausal patients occupied 18.7%. Proportion of early stages/total cervical cancers is 18.5% among which: stage IA: 5.1%; IB: 8.8% and IIA: 5.5%. The first diagnostic clinical manifestation: intermenstrual bleeding: 73%, postcoital bleeding: 9.5% combined with other favorizing factors: age of first coitus, number of sexual partners, number of children, lifestyle (socioeconomy status, cigarette smoking). Cytology or/and histopathology diagnosis and staging based on Pap-smear with cytological exam: HSIL: 13.3%, Microinvasive: 40%, Invasive: 46.7%; Colposcopy: inflammation: 14.3%, budding: 63.5%, ulcerative: 9.5%. And biopsy of the cervix: epitheliocarcinoma: 85.7%, adenocarcinoma: 14.3%; Post-operatory pelvic nodal metastasis: 18.4%; unsafety of cutting field: 3.5%. Essential surgical treatment is Wertheim-Meigs’ Operation in conjunction with adjuvant therapy, chemotherapy, Radiotherapy. DFS of 3 years: 77.9%, of 5 years: 62.3%; OS of 3 years: 81.5%, of 5 years: 74.2%. Conclusion This study illustrated a low proportion of early-stage cervical cancers in Can Tho, in comparing with others authors. In the highly populated area of Mekong Delta region, cervical cancer screening programme was vital. The primary surgical treatment was the essential management for the early stages, as early diagnosis implies sooner radically treatment with a high proportion of DFS and OS of 3 or/and five years.