Prognostic Impact of Histopathology in Patients with Advanced Stage Cervical Carcinoma Treated with Radiotherapy

Introduction: cervical cancer is the fourth most common cancer in women worldwidev . most patients in developing countries including bangladesh present at advanced stage. histopathological types of cervical cancer influence the treatment outcome when treated by radiation therapy. objective: to determine the disease free survival (dfs) in different histopathological types in advanced stage cervical carcinoma treated with radiotherapy. methods: a prospective cohort study was conducted in gynaecological oncology outpatient department (gopd) of national institute of cancer research & hospital (nicrh), dhaka for one year from september’2016 to july’2017. advanced stage (iib-ivb) cervical cancer who completed radiation therapy and histopathological type either squamous cell carcinoma or adenocarcinoma of cervix were included in this study. results: the median follow-up time was 1.82 years; range was 8 to 24 months. average disease free survival (dfs) was 1.53years in squamous cell carcinoma (ssc) and 1.51 years in adenocarcinoma (adc). local recurrences was higher in adenocarcinoma group (62.5%) than squamous cell carcinoma (30.5%) & the difference was statistically significant (p = 0.001). loco-regional recurrence and distal recurrence were also higher in adc than ssc but results were not statistically significant (p=.345, p=.795). in multivariate analysis it was shown that histopathological type and stage of disease were found to be independently significant prognostic factors for dfs, hazard ratio were 1.766 (p=.018) and 2.173 (p=.006). conclusion: adenocarcinoma was a poor prognostic factor for patients with locally advanced cervical carcinoma. advanced stage of disease was also significant predictor for disease free survival.