Primary treatment patterns and survival of cervical cancer in Sweden: A population-based Swedish Gynecologic Cancer Group Study

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@article{b821bca25168400cb479bb42d58248ab,
title = "Primary treatment patterns and survival of cervical cancer in Sweden: A population-based Swedish Gynecologic Cancer Group Study",
abstract = "Objective: Survival in cervical cancer has improved little over the last decades. We aimed to elucidate primary treatment patterns and survival. Methods: Population-based study of patients included in the Swedish Quality Registry for Gynecologic Cancer diagnosed 2011–2015. Main outcome was 5-year relative survival (RS). Age-standardised RS (AS-RS) was estimated for the total cohort and for the pooled study population of squamous, adenosquamous-, adenocarcinoma. Results: Median follow-up time was 4.6 years. The study population consisted of 2141 patients; 97{\%} of the 2212 patients in the total cohort and the 5-year AS-RS was 71{\%} and 70{\%}, respectively. RS stage IB1: surgery alone 95{\%} vs. 72{\%} for definitive chemoradiotherapy (CT-RT) (p < 0.001). In stage IIA1 74{\%} had CT-RT, and 47{\%} of operated patients received adjuvant (CT)-RT. RS stage IB2: surgically treated 81{\%} (69{\%} received adjuvant (CT)-RT) vs. 76{\%} for (CT)-RT (p = 0.73). RS stage IIB: 77{\%} for CT-RT + brachytherapy (BT), 37{\%} for RT + BT (p = 0.045) and 27{\%} for RT-BT (p < 0.001). Stages III-IVA; <40{\%} received CT-RT + BT, RS 45{\%} vs. 18{\%} for RT-BT (RR 4.1, p < 0.001). RS stage IVB 7{\%}. Conclusion: Primary treatment of cervical cancer in Sweden adhered to evidence-based standard of care. Areas of improvement include optimising treatment for stages III-IVA, and avoiding combining surgery and radiotherapy.",
keywords = "Cervical cancer, Radiotherapy, Surgery, Survival, Treatment",
author = "Maria Bjurberg and Erik Holmberg and Christer Borgfeldt and Angelique Fl{\"o}ter-R{\aa}destad and Pernilla Dahm-K{\"a}hler and Elisabet Hjerpe and Thomas H{\"o}gberg and Preben Kj{\o}lhede and Janusz Marcickiewicz and Per Rosenberg and Karin St{\aa}lberg and Bengt Tholander and Kristina Hellman and Elisabeth {\AA}vall-Lundqvist",
year = "2019",
month = "11",
doi = "10.1016/j.ygyno.2019.08.022",
language = "English",
volume = "155",
pages = "229--236",
journal = "Gynecologic Oncology",
issn = "1095-6859",
publisher = "Academic Press",
number = "2",

}