BACKGROUND

Radical hysterectomy, the surgical removal of the uterus, cervix, upper vagina, parametria, and associated tissues, along with bilateral pelvic lymph node dissection, is the global gold standard for treating early-stage cervical carcinoma. Over 110 early-stage cervical cancer patients have undergone this procedure at our institution for the past 10 years. However, data on long-term survival outcomes in the region remain unavailable. Including this information highlights the scale of the institution's experience, adding valuable context to the study. This study evaluates the institution's performance since adopting the procedure and aims to inform patient selection and treatment strategies, leveraging insights from studies conducted in varied clinical settings.

METHODS

This retrospective cohort study analyzed women who underwent radical hysterectomy for early-stage cervical cancer (IB1-IIA2) at Bugando Medical Centre (2014-2020). Data were collected from patient charts, including demographics, histology, clinical stage, surgical details, therapies, and follow-up outcomes. Patients with incomplete procedures, histology, or follow-up data were excluded. Data analysis, performed using Epi Info™ and STATA version 13, included survival probabilities calculated by the Kaplan-Meier method and group comparisons using the log-rank test. Descriptive statistics summarized patient characteristics, and chi-square tests analyzed categorical variables. A p-value of < 0.05 was considered statistically significant.

RESULTS

86 patients were reviewed, with the majority (80.2%) being under 60 years of age and a mean age of 51 ± 10.0 years. The 3-year overall survival rate was 96.5%, disease-free survival was 79.1%, and the recurrence rate was 20.9%. Factors significantly associated with 3-year disease recurrence included: tumour size ≥ 4 cm (log-rank χ²(1) = 19.53, p < 0.001), poorly differentiated tumour grade (log-rank χ²(2) = 11.27, p = 0.004), adenocarcinoma histology (log-rank χ²(1) = 18.79, p < 0.001), vaginal vault involvement (log-rank χ²(1) = 83.03, p < 0.001), and surgical margin involvement (log-rank χ²(1) = 67.81, p < 0.001). No significant association was found between the mode of treatment (neoadjuvant, surgery alone, or adjuvant) and disease recurrence (p = 1.553).

CONCLUSION

The 3-year overall survival rate following radical hysterectomy was 96.5%, with a recurrence rate of 20.9%. Factors associated with recurrence included tumour size ≥ 4 cm, poorly differentiated tumour grade, adenocarcinoma histology, vaginal vault involvement, and positive surgical margins.