Surgeons’ Errors in the Management of Patients with Cervical Cancer

Background and Aim: Generally, in patients with cervical cancer, careful preliminary evaluation is necessary for avoiding improper surgical procedures and making effective clinical decisions for treatment. The aim of this study was to determine surgeons’ errors, which necessitate a combination of surgery and radiotherapy for cervical cancer patients.    Methods: In this retrospective study, medical records of all cervical cancer patients, undergoing hysterectomy at tumor clinics of Ghaem and Omid hospitals, were collected from 1988 to 2008. In total, the medical records of 93 subjects with postoperative radiotherapy were examined. All records were assessed in terms of surgeons’ errors, patients’ follow-up after radiotherapy, rate of disease recurrence, and mortality rate. In addition, survival factors were recorded and assessed, and cumulative 3- and 5-year disease-free survival (DFS) rates as well as overall survival (OS) rate were determined by Kaplan–Meier test. Results: The overall rate of surgeons’ errors was 41%. The most common surgical error was improper surgical care due to surgeon’s lack of knowledge about the cervical cancer treatment. The 3-year DFS rates were 86% and 64% in cases without surgeon’s error and those affected by surgeon s error, respectively. In addition, the 5-year DFS rate was 53% in the non-affected group and 47% in cases affected by surgeon s error (P=0.05).      Conclusion: Pre-treatment evaluation as well as proper treatment is necessary for the prevention of adverse effects, caused by inappropriate surgical interventions. It is suggested that more time and attention be allocated to the improvement of surgical outcomes.

Keywords:

Cervical Cancer , Improper surgery , Subtotal hysterectomy , Supracervical hysterectomy , Surgical error