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.
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.
Authors: Erin M George; Ana I Tergas; Cande V Ananth; William M Burke; Sharyn N Lewin; Eri Prendergast; Alfred I Neugut; Dawn L Hershman; Jason D Wright Journal: Gynecol Oncol Date: 2014-04-24 Impact factor: 5.482
Authors: Holm Eggemann; Tanja Ignatov; Christina Henrike Geyken; Stephan Seitz; Atanas Ignatov Journal: J Cancer Res Clin Oncol Date: 2018-03-02 Impact factor: 4.553
Authors: Yoon-Jung Kang; Dianne L O'Connell; Robert Lotocki; Erich V Kliewer; David E Goldsbury; Alain A Demers; Karen Canfell Journal: BMC Cancer Date: 2015-09-22 Impact factor: 4.430
Authors: Tomasz Basta; Paweł Knapp; Paweł Blecharz; Lubomir Bodnar; Iwona Gawron; Dorota Babczyk; Magdalena Piróg; Tomasz Kluz; Anna Markowska; Anna Horbaczewska; Robert Jach Journal: PLoS One Date: 2019-01-31 Impact factor: 3.240