Treatment outcome of cervical cancer patients at Ocean Road Cancer Institute, Dar es salaam

ABSTRACT Background: Cervical cancer is the second commonest malignancy in females globally. Cancer of the cervix has a devastating impact on women’s health in developing countries especially Africa since more than 75% of the worldwide burden of the disease occurs in these countries. It is the leading malignancy among women in Tanzania. Patients’ late presentation to hospitals and poverty lead to very poor treatment outcome of the disease. Many of these countries put much resources and efforts on the treatment aspect of the disease, and hence the need to investigate the treatment outcome among patients with cervical cancer. Objectives: To describe the treatment outcome among patients diagnosed to have cervical cancer and treated at the Ocean Road Cancer Institute (ORCI). Methodology: The study was a retrospective review of case files of women with histologically proven cancer of cervix who were treated at ORCI from 1st January to 31st December 2007. Each individual had had a three year follow up as of 31st December 2010. Patients file number, residence and phone numbers were obtained from a registration book, files were then collected and the required information extracted using a designed checklist. Results: A total of 630 patients were included in the study with median age of 51 years (± 12.7 SD), range of 24 - 90 years. At the end of a three-year follow-up of these patients, 135 (21.4%) were alive and 114 (18.1%) had died while 381 (60.5%) were lost to follow-up; number of lost in follow up was increasing in subsequent years. More than three quarters of patients presented with advanced stage of the disease (beyond stage IIb, and squamous cell carcinoma was the most common (> 90%) whereas a few had adenocarcinoma and adenosquamous. Majority of patients (83.7%) were treated with teletherapy (external beam radiation) only while a very few patients had an addition of brachytherapy Conclusion: Most patients presented with advanced stage of the disease. External beam radiation was seen to be the mode of treatment which was given to most of the patients, dose of radiation given as well as the stage of cervical cancer play a big role in the treatment outcome. Adherence to the follow up clinics seems to be a problem to most of patients, hence the outcome of treatment to most of patients was difficult to assess though the outcome seems to be poor Recommendation: More centers for cancer detection and treatment are needed national wide,installation of national cancer registry and cancer treatment protocols is very important