Abstract
Objective
This study aims to describe trends and variation in treatment and survival of cervical
cancer in two regions in The Netherlands and to relate this to adherence to the treatment
recommendations.
Study design
Patient characteristics, tumour characteristics, treatment and follow-up data were
collected for 1954 cervical cancer cases diagnosed in the period 1989–2004.
Results
In FIGO stages IB-IIA 93% of patients were treated according to the recommendations
of The Netherlands Working Group Gynaecologic Oncology. Older patients received radiotherapy
more often than younger patients: 48% (95%CI 40–57) of patients older than 70 compared
to 15% (95%CI 10–20) of patients aged 50–69 and 5% (95%CI 3–7) of patients aged 50
or younger (p < 0.05). In FIGO stages IIB-IVA 76% of patients were treated according to the recommendations
of the Working Group. Chemoradiation was given to older patients less often than to
younger patients: 2% (95%CI 0.5–5) versus 23% (95%CI 16–29). A decreased risk of death
was found for patients receiving chemoradiation (RER 0.6, 95%CI 0.3–0.9) compared
to those receiving “radiotherapy only”.
Conclusion
Far from being always followed, the treatment recommendations were better implemented
for treatment of patients with FIGO IB-IIA. Elderly patients received different treatment
compared to younger patients in this study and showed an independent increased risk
of death in the lower stages, which confirms that the need becomes stronger for paying
attention to treatment of elderly patients.
Keywords
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Article info
Publication history
Published online: August 12, 2009
Accepted:
July 22,
2009
Received in revised form:
May 7,
2009
Received:
September 2,
2008
Identification
Copyright
© 2009 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
