Jita Parija, Janmejaya Mohapatra
Oncosurgery plays a very important role in management of gynaecological cancers. With modern anaesthetic techniques, blood transfusion services and intensive care facilities, gyn-oncosurgery in the form of primary radical/secondary cytoreductive or palliative surgery can be offered to patients in all stages of cancer. This is a retrospective analysis of gynaecologic cancer cases who underwent surgery with or without chemotherapy. The study aims at observing the response of these individual cancers to surgery alone or surgery and adjuvant therapy and calculates the 5-year disease-free survival of these cases.
MATERIALS AND METHODS
A total number of 2242 gynaecological cancer patients who underwent various surgical procedures during April 2006-March 2011 were taken up for studying their individual response to the particular surgery. The patients were categorised into sitespecific gynaecological cancers and the type of surgery they underwent was noted. Adjuvant treatment if given was noted. All patients were followed up for 5 years or more.
It was observed that of the total number of female genital cancers attending the gyn-oncology OPD of A.H. Regional Cancer Centre over a period of 5 years, only 11.6% were operable. In case of uterine cancers, postoperative adjuvant radiotherapy was required in 28.4% of cancer cervix and in 23.7% cancer corpus patients. All cases of cancer ovary needed adjuvant therapy (chemotherapy/chemotherapy and radiotherapy). All cases of cancer vagina required postoperative adjuvant radiotherapy, whereas none of the vulval cancers needed radiotherapy. Five-year disease-free survival was 75.4% in cancer cervix, 100% with cancer uterine corpus and vulvovaginal cancers and 66.7% with ovarian cancers.
This retrospective analysis reveals that surgery alone should be the primary mode of treatment for all operative gynaecological cancers. Adjuvant treatment should be offered when and wherever necessary.