RADICAL HYSTERECTOMY FOR EARLY-STAGE CERVICAL CANCER IN A LOWRESOURCE SETTING: SURGICAL OUTCOMES AND LESSONS FROM A...

Area of Science:

• Gynecologic Oncology
• Surgical Oncology
• Public Health

Background:

• Cervical cancer disproportionately affects women in low- and middle-income countries, particularly in Sub-Saharan Africa.
• Delayed diagnosis in low-resource settings often leads to advanced-stage disease, precluding curative surgical options.

Purpose of the Study:

• To assess the feasibility and outcomes of radical hysterectomy (RH) for early-stage cervical cancer.
• To evaluate the safety and efficacy of this infrequently performed procedure in a Nigerian tertiary hospital.

Main Methods:

• Retrospective review of 7 radical hysterectomy cases performed in 2024 at Lagos State University Teaching Hospital (LASUTH), Nigeria.
• Data collection included demographics, operative details, histopathology, and outcomes; bilateral internal iliac artery ligation was routine.
• Descriptive statistical analysis was employed.

Main Results:

• The cohort presented after a mean of 28.29 symptom weeks, with 71.4% delaying care over a month; no patients had prior screening.
• Mean surgery duration was 177.14 minutes with 655 mL estimated blood loss; histology revealed predominantly squamous cell carcinoma (85.7%).
• Postoperative complications included parametrial involvement (28.6%) and nodal metastasis (20%); 14.3% experienced neurogenic bladder, resolving conservatively. All patients survived 12 months.

Conclusions:

• Radical hysterectomy is demonstrated as safe and feasible in a Nigerian tertiary center, even with a small series and short follow-up.
• The study underscores persistent gaps in cervical cancer screening and timely referral, limiting surgical eligibility.
• Addressing these systemic issues is crucial to increase the number of women eligible for potentially curative surgical interventions.