Introduction Early-stage cervical cancer cases are still recorded among young age patients despite awareness about screening and vaccination. Fertility preserving surgery is the management of choice for those age group. Previously, radical trachelectomy was done with different approaches. Nowadays, Roboticassisted surgery is replacing previous techniques for better outcomes. This video is representing Robotic-assisted radical vaginal trachelectomy. Description Robotic Phase -Sentinel pelvic lymph-node sampling -Dissection of pelvic spaces ( Para-vesical, para-rectal ) -Ureterolysis -Dissection of vesicouterine ligaments, cardinal ligaments, uterosacral lligaments -Colpotomy .
Our curative RT eligibility criteria were TNM Stage T 3, N 1; AJCC Stage IIB to IIIC; and undergoing lumpectomy. This study received domestic and international Institutional Review Board approval. Results We reviewed 441 patient records. The mean age was 53.0 years and 56.0% of patients presented with Stage IIIA-C breast cancer. The median distance traveled for RT was 155 km (range = 3.3-1082 km). We had surgery data on 313 patients (71%) with 41.0% of patients undergoing mastectomies and 11.3% undergoing lumpectomies. Most patients presented with a Karnofsky Performance Status of 90-100 (84.1%). The majority of patients were eligible for curative RT (340; 77.1%), however, only 150 (44.1%) went on to initiate radiation treatment. The median dose received was 4500 cGy and the median boost dose was 900 cGy. Univariate logistic regression analysis revealed the following variables as significantly associated with initiating RT: Mastectomy (p<0.001) and Karnofsky Performance Status >90 (p = 0.04). Conclusions This study identified a sizable gap in RT uptake among patients with breast cancer in Botswana, with only 44.1% of eligible patients initiating treatment. Since radiation therapy is covered by the government, it is imperative to consider other factors that could contribute to the lack of treatment initiation, including health literacy and RT schedules with downtime.
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