Retrospective analysis of patients with cancer of the cervix attending a radiotherapy outpatient department: experience from a university-based hospital in eastern Uttar Pradesh, India

Abstract

Objective: A retrospective analysis of all patients with cancer of the cervix attending a radiotherapy outpatients department in a single unit from January 2005 to December 2006 was carried out to study their epidemiology, stage and status of presentation, compliance with treatment and follow-up, as well as response and complication rates. Design: This was a retrospective study. Setting and subjects: Four hundred and ninety-five consecutively registered patients with cancer of the cervix were included in the study, which was carried out between January 2007 and December 2008. Outcome measures: The epidemiology, stage and status of presentation, compliance with treatment and follow-up, as well as the response and complication rates of the treated patients were the outcome measures. Results: Most of the patients hailed from the various districts of Uttar Pradesh (58%) and Bihar (32%), India. The majority (> 50%) were aged 40-59 years. Stage information was available for 70% of the patients, of which stage 1 comprised 5%, stage 2, 36%; stage 3, 56%; and stage 4, 3%. Squamous cell carcinoma was the most common reported histopathology (~90%). A significant proportion of the women defaulted after registration, or after undergoing investigations (34%). Of the 65% cases planned for treatment, 50% initiated it, but only 35% completed it, according to protocol. Radical radiotherapy was planned for the majority of women (>90%) with or without chemotherapy. Compliance with follow-up was poor (26%). At the time of the analysis, 63% patients had a complete response, 12% residual disease, 16% progressive disease and 7% locoregional recurrence. Recorded late complications were mostly grade I and II bladder and rectal toxicity. Conclusion: The outcome of this study will significantly help us to define region-specific strategies needed for the management of cervical cancer in eastern Uttar Pradesh, India.