Squamous cell carcinoma of the uterine cervix at the Dakar Cancer Institute

Objectives: To determine the epidemiological characteristics of patients with squamous cell carcinoma of the cervix, to describe its forms and to assess the treatment they received. Materiel and methods: This retrospective study examined records of 616 cervical carcinomas at Dakar Cancer Institute from 1977 to 1999. All cases of squamous cell carcinoma were included, and their epidemiological, clinical and therapeutic aspects described. Five-year survival was calculated by the actuarial method. Results: Patients' mean age was 35 years, and 86% were older than 35 years. Mean parity was 8 and 44.4% of patients had reached menopause. According to the FIGO classification, 419 patients had advanced stage (lib, III, IV) cancers, and tumours were histologically differentiated in 20.1% of cases. Radical hysterectomies were performed for 252 patients (40.9%). In all, 152 patients (24.67%) received external neoadjuvant radiation therapy and 69(11.2%) adjuvant radiation therapy. Postoperative complications included urinary fistulas, lymphoceles, and phlebitis. Recurrence was seen in 133 cases and was significantly associated with stage and time until radiation therapy. Conclusion: Curietherapy might improve our treatment of these advanced cervical cancers. Their prevention requires the establishment of facilities for early diagnosis and population screening for detection of precancerous lesions of the cervix. The vaccinal approach recently introduced in developed countries appears to be too costly for developing countries today.