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Cervical cancer in French Guiana before the implementation of the University Hospital: Outcome and prognosis
Hemerson Guevara1, Najeh Hcini2, Béatrice Virjoghe1
1Outpatients Clinic, Cayenne Hospital, avenue Alexis-Blaise, 97300 Cayenne, French Guiana.
Objectives:
Cervical cancer is common in French Guiana. Previous studies of the cancer registry have shown that the only prognostic factor was FIGO stage, with a 5-year survival rate of 58%. This study aimed to describe the management and survival rates prior to the establishment of the University Hospital.
Methods:
A multicenter retrospective study of 222 cases discussed in tumor board meetings between 2010 and 2021. Data collected included age, administrative status, comorbidities, place of residence, histology, FIGO stage, treatment modalities, and disease progression.
Results:
Key findings were median age, 48 years; born abroad, 59%; residence on the Atlantic coast, 68%; FIGO stage III-IV, 54%; surgery, 47% of cases; radiotherapy, 46%; transfer outside French Guiana, 58%. Five-year overall survival was 65%, identical before and after 2016. In multivariate analysis, advanced FIGO stages (III, HR=3.22; IV, HR=3.65) and residence in remotes areas (HR=2.63) were independent prognostic factors for shorter survival.
Discussion:
Difficulties in accessing care and mandatory transfers for radiotherapy impact patient outcomes. Recent decisions have been made within the framework of the new University Hospital (CHU), notably the establishment of a radiotherapy department and the strengthening of local healthcare infrastructure. These results provide a baseline for evaluating the impact of these decisions.
