ARE RECOMMENDATIONS FROM CARCINOMA OF THE CERVIX PATTERNS OF CARE STUDIES (PCS) IN THE UNITED-STATES-OF-AMERICA (USA) APPLICABLE TO CENTERSIN DEVELOPING-COUNTRIES

Purpose: To compare patient demographics, treatment resources, practic e patterns, and outcome results for squamous cell carcinoma of the ute rine cervix (SCC) between the 1978 and 1983 Patterns of Care studies ( PCS) in the United States of America (USA) and a nonacademic center wi thin a developing country, Method and Materials: Patient details (race , age, stage, and number per year), treatment used, and treatment outc ome were retrieved from the charts of the 1160 cases registered at thi s center with SCC of the cervix between 1976 and 1985, Demographic var iables and Kaplan-Meier survival estimates were calculated and compare d with results from published PCS reviews, Results: There is a signifi cant difference in the racial group presentation of cervix cancer at t his center compared with the PCS reviews (p < 0.005), and median ages are significantly lower at this center (t = p < 0.001), The proportion of patients with Stage III or more was significantly higher at this c enter than the PCS centers (24 vs, 47%,p < 0.001), There were also vas t differences in facility resources, Fewer cases at this center underw ent intracavitary insertions than at PCS centers. Mean Point A doses w ere significantly reduced for this center compared with the PCS review s. Kaplan-Meier estimates were similar for Stage I and II in PCS cente rs and this center, but were inferior for this center in Stage III pat ients (p < 0.05 for OS and p < 0.01 for LC), Late morbidity rates were similar for both PCS centers and this center, Conclusion: PCS recomme ndations may be applicable to nonacademic centers within developing co untries, if the latter use staging techniques that are consistent with the PCS staging guidelines, (C) 1997 Elsevier Science Inc.