The incidence, management, and outcomes of stage IIIB cervical cancer in a middle-income setting

Authors

DOI:

https://doi.org/10.36303/SAJGO.407

Keywords:

cervical cancer, HIV, hydronephrosis, middle-income countries, radiotherapy, stage IIIB cervical cancer, cervical cancer prognosis

Abstract

Background: Cervical cancer is the second most common cancer in South Africa, and most women present with stage III disease. Hydronephrosis is a frequent complication of advanced disease, and it is associated with poorer clinical outcomes.

Aim: This review aims to evaluate the management and outcomes of patients with stage IIIB cervical cancer and determine if the presence of hydronephrosis adversely influences the outcome in this disease stage.

Methods: A retrospective audit was conducted to assess the clinical data of patients treated for stage IIIB cervical cancer at Groote Schuur Hospital (GSH) between January 2017 and December 2018. The data collected included demographics, human immunodeficiency virus (HIV) status, comorbidities, pelvic sidewall involvement, presence of hydronephrosis, treatment intent and modalities, nephrostomy referral, treatment response, and survival outcome.

Results: A total of 132 patients were deemed eligible for our study, with a mean age of 52 years. The median overall survival (OS) was 15 months, and the median disease-free survival (DFS) for patients who completed radical treatment was 13 months. HIV status was the only factor that affected OS (p = 0.05) and DFS (p = 0.03). Neither age nor the presence of hydronephrosis influenced OS or DFS (p > 0.05).

Conclusion: Hydronephrosis did not affect OS or DFS. HIV was associated with an increased incidence of stage IIIB cervical cancer, and a negative prognostic factor for OS and DFS.

Author Biographies

  • Z Dalvie, University of Cape Town

    Faculty of Health Sciences, University of Cape Town, South Africa

  • TS Adams, University of Cape Town

    Faculty of Health Sciences, University of Cape Town, South Africa

  • N Fakie, University of Cape Town

    Faculty of Health Sciences, University of Cape Town, South Africa

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Published

2025-06-19

Issue

Vol. 17 No. 1 (2025)

Section

Original Research

License

Copyright (c) 2025 Author/s

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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

South African Journal of Gynaecological Oncology (SAJGO) Copyright is held by South African Society of Gynaecologic Oncology (SASGO). Copyright of the articles is held by the authors. The work is licensed under a Creative Commons Attribution-Non-Commercial Works 4.0 South Africa License (CC BY NC). Material submitted for publication in the SAJGO is accepted provided it has not been published elsewhere. The SAJGO does not hold itself responsible for statements made by the authors. The opinions expressed in this publication are those of the authors. They do no purport to reflect the opinions or views of SASGO or its members.