Summary:
Introduction: Cervical cancer is the fourth most common
cancer in women worldwidev . Most patients in developing
countries including Bangladesh present at advanced stage.
Histopathological types of cervical cancer influence the
treatment outcome when treated by radiation therapy.
Objective: To determine the disease free survival (DFS) in
different histopathological types in advanced stage cervical
carcinoma treated with radiotherapy.
Methods: A prospective cohort study was conducted in
Gynaecological oncology outpatient department (GOPD)
of National institute of Cancer Research & Hospital
(NICRH), Dhaka for one year from September’2016 to
July’2017. Advanced stage (IIB-IVB) cervical cancer who
completed radiation therapy and histopathological type
either squamous cell carcinoma or adenocarcinoma of cervix
were included in this study.
Results: The median follow-up time was 1.82 years; range
was 8 to 24 months. Average disease free survival (DFS) was
1.53years in squamous cell carcinoma (SSC) and 1.51 years
in adenocarcinoma (ADC). Local recurrences was higher in
adenocarcinoma group (62.5%) than squamous cell
carcinoma (30.5%) & the difference was statistically
significant (p = 0.001). Loco-regional recurrence and distal
recurrence were also higher in ADC than SSC but results
were not statistically significant (p=.345, p=.795). In
multivariate analysis it was shown that histopathological
type and stage of disease were found to be independently
significant prognostic factors for DFS, hazard ratio were
1.766 (p=.018) and 2.173 (p=.006).
Conclusion: Adenocarcinoma was a poor prognostic factor
for patients with locally advanced cervical carcinoma.
Advanced stage of disease was also significant predictor for
disease free survival.
Key ward: cervical carcinoma, advanced stage,
histopathological, radiotherapy.
(J Bangladesh Coll Phys Surg 2019; 37: 175-180)
DOI: http://dx.doi.org/10.3329/jbcps.v37i4.43346