BACKGROUND

Cervical cancer is a common malignancy among Filipino women, treated through surgery, chemotherapy, or radiation. To improve outcomes and reduce costs, the European Society of Gynaecological Oncology (ESGO) established 15 quality indicators for its surgical management. The aim of the study was to evaluate the quality of cervical cancer surgeries at a tertiary government hospital in the Philippines, using ESGO quality indicators.

METHODS

A descriptive retrospective review was conducted on medical records of early-stage cervical cancer patients who underwent radical surgery from January 1, 2019, to December 31, 2021. Data were collected using ESGO’s 15 quality indicators. Incomplete records were excluded from the study. Descriptive statistics and Kaplan–Meier analysis were used.

RESULTS

Fifty-four patients underwent surgery, averaging 18 cases per year. Most surgeries (75.93%) were supervised by certified gynecologic oncologists, and 85.2% were discussed in multidisciplinary conferences. All patients had appropriate preoperative assessments and metastatic imaging. Pathology reports met the required standards, and lymph node staging was achieved in all cases. Adequate lymph node harvest was 68.18% (pelvic) and 65.91% (paraaortic). Fertility counseling was provided, although none pursued fertility-sparing treatment. Surgical complications included two vesicovaginal fistulas (3.7%). Clear margins were achieved in 92.59%, with 24.30% upstaged postoperatively. Adjuvant chemoradiotherapy rates were highest in 2019 (93.33%). No recurrences were noted for stage IB1 after a median 34-month follow-up.

CONCLUSION

The surgeries met ESGO quality standards, demonstrating that these indicators can be adapted locally, ensuring quality assurance in care.

Human

Although commonly seen in the ovary, fallopian tube, peritoneum, and endometrium, the serous carcinoma histology is considered a rare subtype when seen in the cervix. The prevalence of cervical adenocarcinoma, including serous carcinoma, varies between 5% and 15% of all cervical malignancies. A thorough literature study revealed only 113 cases of serous carcinoma of the cervix, highlighting its infrequency relative to other cervical cancer variants. As a subtype of adenocarcinoma, serous carcinoma of the cervix has aggressive characteristics and usually unfavorable prognosis, more so its clinicopathological characteristics are relatively unclear because of its rarity and limited number of cases and reviews seen in literature. This is a case of a 44-year-old G3P3 with a primary complaint of heavy vaginal bleeding. The diagnosis of serous carcinoma of the cervix was made by histopathological evaluation, confirmed by immunostaining. With physical examination and diagnostic imaging confirming an early stage disease, the patient successfully underwent primary surgical management.

Human ; Female ; Uterine Cervical Neoplasms