A retrospective audit of treatment pathway for women diagnosed with cervical cancer in the Auckland region 2012–2016

Abstract

Introduction: The purpose of this study was to describe the treatment pathway and timelines of patients diagnosed with FIGO stage IB1-IVA cervical cancer receiving definitive radiotherapy +/À chemotherapy and the potential improvements made since the previous audit and impact on overall survival (OS), disease-free survival (DFS) and local control (LC). Methods: This is a retrospective audit on patients diagnosed with FIGO Stage 1B1-IVA cervical cancer in the Northland/Auckland region of New Zealand between 2012 and 2016. Results: There were 95 patients identified. Median time from referral to start of treatment was 69 days, from referral to first specialist assessment (FSA) 11 days, from FSA to decision to treat (DTT) 41 days and from DTT to start treatment 21 days. There was no statistical difference in time from referral to start of treatment between patients treated with radiotherapy alone or with combined chemoradiotherapy (P < 0.1695). Private FSA (P < 0.0115) and shorter time from MDM to completion of radiological investigations (P < 0.0001) were associated with shorter median times from referral to start of treatment. Median overall treatment time (OTT) was 43 days. The 3-year OS, LC and DFS were all 100% for Stage IB, 78%, 95% and 78% for Stage II, 79%, 88% and 77% for Stage III and 58%, 57% and 43% for Stage IV. Conclusion: There has been some overall improvement in the treatment pathways, and OTT was less than the recommended 8 weeks. Our 3-year OS, LC and DFS were comparable with international standards.