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Primary treatment patterns and survival of cervical cancer in Sweden: A population-based Swedish Gynecologic Cancer Group Study

Journal article
Authors M. Bjurberg
Erik Holmberg
C. Borgfeldt
A. Flöter-Rådestad
P. Dahm-Kähler
E. Hjerpe
T. Högberg
P. Kjølhede
J. Marcickiewicz
P. Rosenberg
K. Stålberg
B. Tholander
K. Hellman
E. Åvall-Lundqvist
Published in Gynecologic Oncology
Volume 155
Issue 2
Pages 229-236
ISSN 0090-8258
Publication year 2019
Published at Institute of Clinical Sciences, Department of Oncology
Pages 229-236
Language en
Links dx.doi.org/10.1016/j.ygyno.2019.08....
Subject categories Cancer and Oncology, Obstetrics and gynaecology

Abstract

Objective: Survival in cervical cancer has improved little over the last decades. We aimed to elucidate primary treatment patterns and survival. Methods: Population-based study of patients included in the Swedish Quality Registry for Gynecologic Cancer diagnosed 2011–2015. Main outcome was 5-year relative survival (RS). Age-standardised RS (AS-RS) was estimated for the total cohort and for the pooled study population of squamous, adenosquamous-, adenocarcinoma. Results: Median follow-up time was 4.6 years. The study population consisted of 2141 patients; 97% of the 2212 patients in the total cohort and the 5-year AS-RS was 71% and 70%, respectively. RS stage IB1: surgery alone 95% vs. 72% for definitive chemoradiotherapy (CT-RT) (p < 0.001). In stage IIA1 74% had CT-RT, and 47% of operated patients received adjuvant (CT)-RT. RS stage IB2: surgically treated 81% (69% received adjuvant (CT)-RT) vs. 76% for (CT)-RT (p = 0.73). RS stage IIB: 77% for CT-RT + brachytherapy (BT), 37% for RT + BT (p = 0.045) and 27% for RT-BT (p < 0.001). Stages III-IVA; <40% received CT-RT + BT, RS 45% vs. 18% for RT-BT (RR 4.1, p < 0.001). RS stage IVB 7%. Conclusion: Primary treatment of cervical cancer in Sweden adhered to evidence-based standard of care. Areas of improvement include optimising treatment for stages III-IVA, and avoiding combining surgery and radiotherapy. © 2019 Elsevier Inc.

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