Objective: To assess current practice for the management of patients with locally advanced cervical cancer in Thailand.

Materials and Methods: Thai gynecologic oncologists who had been practicing in the field for at least one year were invited to complete an on-line self-administered questionnaire. The survey encompassed general aspect and organ-specific aspect of care including management of cervical cancer, endometrial cancer, and ovarian cancer. This study represents a part of the main study that addressed locally advanced cervical cancer management.

Results: One hundred seventy gynecologic oncologists responded to the survey questionnaires. Seventy-eight percent of the respondents treated the patients with bulky early stage IA3 and IIA2 by concurrent chemoradiation, followed by neoadjuvant chemotherapy (22.4%) and surgery alone (11.8%).  Almost all of respondents preferred to use concurrent cisplatin-based chemoradiation for the patients with locally advance stage IIB to IVA. However, only 1.8% of them consider other treatment modalities. The more effective treatment modalities have been identified in order to improve the outcome and reduce toxicity of standard treatment. The large disparity was observed in some controversial treatment issues, including ovarian transposition, neoadjuvant chemotherapy followed by surgery, surgical staging for nodes assessment, adjuvant chemotherapy after concurrent chemoradiation, and adjuvant hysterectomy.

Conclusion: The majority of Thai gynecologic oncologist managed the patient with LACC by mostly following the standard guideline. However, there are the variation of practice pattern in some controversial issues.

Keywords: cervical cancer; gynecologic oncologist; practice pattern