Primary treatment of cervical carcinoma - Ten years experience from one Norwegian health region

Objective. To study the primary care of cervical carcinoma with regard to clinical and pathological factors, treatment decisions, complications and survival. Design. A historical cohort comprising all women hospitalized with invasive cervical carcinoma (n=293) during the period 1987-1996. Results. Median age was 52 years (range 23-90). FIGO stage distribution was 62%, 15%, 18% and 5%, in stages I, II, III and IV, respectively. Early stage disease correlated with young age. Histologic types were: squamous cell carcinoma 84%, adenocarcinoma 11%, adenosquamous carcinoma 4% and small cell/anaplastic carcinoma 1%. Primary therapies were: surgery 188 women (64%), radiotherapy 99 women (34%), chemotherapy two women (0.7%); four women not treated (1.3%). Complications after surgery in 25 women (13%), none were fatal. Acute or late complications after primary or postoperative radiotherapy in 39 women (25%), seven (4.6%) were late serious complications. Three women died from complications related to radiotherapy. Mean follow-up of surviving patients was 58 months. Overall disease specific five-year survival was 70%,. Five-year survival in stages IA, IB, II and III was 100%, 88%, 58% and 20%, respectively. One-year survival in stage IV was 31%. Median survival in stages III and IV according to curative or palliative aim of treatment was 20 and 6 months, respectively (p<0.005). Conclusion. Satisfactory quality of diagnosis and therapy have been maintained through regional care for cervical cancer patients.