Surgical management of cervical cancer in a resource‐limited setting: One year of data from the National Cancer Institute, Sri Lanka

• Published in: International journal of gynecology and obstetrics 2021-01, Vol.152 (1), p.78-81
• Main Authors: Patabendige, Malitha, Wijesinghe, Rajitha D., Wijesuriya, M.W.A.B., Hapuachchige, Chinthana
• Format: Article
• Language: English
• Subjects: Cervical cancer; Cervical Intraepithelial Neoplasia - diagnostic imaging; Cervical Intraepithelial Neoplasia - pathology; Cervical Intraepithelial Neoplasia - surgery; Databases, Factual; Developing Countries; Female; Humans; Hysterectomy - statistics & numerical data; Middle Aged; Neoplasm Staging; Outcome Assessment, Health Care; Papillomaviridae - isolation & purification; Papillomavirus Infections - diagnostic imaging; Papillomavirus Infections - pathology; Papillomavirus Infections - surgery; Retrospective Studies; Sri Lanka; Surgery; Tomography, X-Ray Computed; Uterine cervical diseases; Uterine Cervical Neoplasms - diagnostic imaging; Uterine Cervical Neoplasms - pathology; Uterine Cervical Neoplasms - surgery
• ISSN: 0020-7292; 1879-3479
• DOI: 10.1002/ijgo.13384

Objective To evaluate the surgical management of cervical cancer without the use of preoperative pelvic imaging in a resource‐limited setting. Methods A retrospective study was carried out using clinical records and the ongoing electronic database at the Gynaecological Oncology Unit, National Cancer Institute (Apeksha Hospital), Maharagama, Sri Lanka. Details regarding the radical hysterectomies carried out from January 1, 2019, to December 31, 2019, were retrospectively studied. Results Out of nearly 700 patients with cervical cancer admitted during the year 2019, 57 surgically managed radical hysterectomies were included. Of these, seven cases were ineligible and excluded and 50 cases of radical hysterectomies were included for analysis. Mean age was 53.6 ± 9.5 years and median parity was 3 (range 2–4). Of the cases, 94% were found to have no parametrial involvement showing the success of clinical examination in assessing local tumor spread. Overall, 11 (22.0%) were upstaged due to lymph node metastasis that was statistically significant. Conclusion Preoperative clinical staging is a practical method in selecting surgically treatable cervical cancer in low‐ and middle‐income countries (LMICs). Combining clinical assessment with comparatively more readily available computed tomography scans could be helpful in triaging patients for treatment of cervical cancer in LMICs. Preoperative clinical assessment and staging is still a practical way of assessing women with cervical cancer in low‐resource settings with limited facilities for pelvic imaging.