Abstract :


Background: Cervical cancer is the fourth most common cancer among women worldwide. In Tanzania, it is the leading malignancy in women with 58% of deaths reported annually. Radical hysterectomy is the recommended treatment for early-stage cervical cancer, but this option only became available at Bugando Medical Centre (BMC) in 2014. The purpose of this study is to provide insight into the efficacy of gynecologic oncology surgery at BMC.

Methods: This is a 5-year retrospective chart review of all patients who underwent radical hysterectomy at BMC between January 2014 and May 2018. Coding data was scripted a priori to provide consistent and accurate data. Microsoft Excel 2007 and STATA version 13 were used for quantitative statistical analysis. Data were summarized in proportions and frequency tables for categorical variables. For continuous variables, data were reported as mean ± Standard Deviation (SD) or IQR. A chi-square test was performed to test for significant associations between the predictor and outcome variables. A significant association was defined as a p-value of less than 0.05.

Results: Sixty-two charts were available for review. The medianage was 49.5 [IQR: 42–57] years. Tumorsin lymph nodes, parametria, and vagina were detected in 12.9%, 9.7%, and 24.2% respectively. Twenty patients (30.6%) had intraoperative complications while seventeen patients (27.4%) presented with early and late postoperative complications. Intraoperative complications were: Hemorrhage (16.1%), ureteral injury (8.1%), and mortality (1.6%) while fistula and bladder dysfunction occurred in 8.1% of patients as early and late complications. The overall cancer survival rate was influenced by tumor size and was predictive of the likelihood of tumor recurrence (P = 0.013).

Conclusions: Radical hysterectomy for early cervical cancer treatment in a low-resource setting provides outcomes equivalent to well-resourced settings.