Surgical Management of Early-stage Cervical Cancer: Survey of Practice among Thai Gynecologic Oncologists
Thiangtham K, MD1, Sermsukcharoenchai N, MD1, Rittiluechai K, MD1, Chanpanitkitchot S, MD2, Hanprasertpong J, MD3, Charoenkwan K, MD4, Thai Gynecologic Cancer Society (TGCS)5
Affiliation : 1 Gynecologic Oncology Division, Department of Obstetrics and Gynecology, Phramongkutklao Hospital, Bangkok, Thailand 2 Department of Obstetrics and Gynecology, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, Thailand 3 Department of Obstetrics and Gynecology, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand 4 Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand 5 Office of the Thai Gynecologic Cancer Society, Bangkok, Thailand
Objective : To acquire a comprehensive picture of the current surgical management of early-stage cervical cancer by conducting an
on-line digital survey among practicing Thai gynecologic oncologists.
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. This study represents a part of the main study that addressed early-stage
cervical cancer management.
Results : One hundred seventy gynecologic oncologists responded to the survey questionnaires. Approximately half of the respondents
would abort the radical hysterectomy procedure if preoperative imaging reveals node enlargement suspected of cancer metastasis.
If pelvic/para-aortic lymph node metastasis was found during operation, more respondents would abandon the procedure especially
for the finding of pelvic node metastasis (65.3%). Thirty-nine respondents (22.9%) reported that they perform laparoscopic surgery
for early-stage cervical cancer. This number had dropped significantly after 2018. Criteria used by the respondents for consideration
of ovarian preservation at the time of radical hysterectomy varied. Approximately half of the respondents indicated that the
combination of criterion including large tumor size, deep stromal invasion, and lymph-vascular space invasion must be met for any
patients to be considered as having intermediate-risk for recurrence.
Conclusion : There are large disparity in the current management of early-stage cervical cancer among practicing Thai gynecologic
oncologists.
Keywords : Cervical cancer, Gynecologic oncologist, Practice pattern
