Invasive carcinoma of the uterine cervix in Iran

To review diagnostic aspects, treatment measures and pathologic findings in patients diagnosed and treated for invasive cervical carcinoma in Shiraz University of Medical Sciences hospitals.

The hospital records of all patients admitted to the Shiraz University of Medical Sciences affiliated hospitals (Nemazee and Saadi hospitals) with newly diagnosed carcinoma of the uterine cervix between January 1985 and December 1995, were reviewed.

204 newly diagnosed patients were admitted with invasive cervical carcinoma of which 61 (30%) were in stage I (FIGO), 96 (47%) in stage II, 34 (16.6%) in stage III and 13 (6%) in stage IV of the disease. Of these 204, the given treatments included surgery in 88 patients, internal and external pelvic radiotherapy in 141, both hysterectomy and pelvic radiotherapy in 22, chemotherapy in eight and cryotherapy in one patient. We found significantly positive relations with stage of the disease and chest roentgenogram (P < 0.02), intravenous pyelogram (P < 0.0002), sigmoidoscopy (P < 0.006) and cystoscopy (P < 0.0045). Of the total number of pathologic specimens, squamous cell carcinoma was reported in 88% and adenocarcinoma in 11%. Recurrence rates of up to 15.5% for stage II and 5% for stage I were calculated. Among the complications for which hospital admission was required, genito-urinary complications were the most frequent.

The recurrence rate in stage I is lower than the estimated recurrence risk in several other studies which can be due to a real advantage of the center's practice. This may pose the question of indispensability for the advanced and expensive diagnostic paraclinical work-ups.