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Surgery for Recurrent Cervical Carcinoma
Andreas J. Papadopoulos (Subspecialty Fellow)
Omer Devaja (Subspecialty Fellow)
Rahul Nath (Research Registrar)
George D. Wilbanks (Visiting Professor)
K. Shanti Raju (Consultant and Director of Department)
Department of Gynaecological Oncology, Guy's and St Thomas' Hospital NHS Trust, London, England
Summary
- Recurrent disease occurs in approximately 35% of cervical cancer cases.
- Evaluation of the patient includes assessing the extent of disease and performance status for surgery.
- Exploratory laparotomy determines the extent of disease and the appropriateness of planned surgery.
- The choice of exenterative procedure varies according to the site and extent of recurrence.
- Exenteration is associated with a significant number of complications, but has achieved 5 year survival rates of between 19-50% in selected patients.
Editor's Comment
The benefits and limitations of surgical approaches to recurrent cervical cancer are carefully appraised in this detailed review. Along with well-established procedures, experimental techniques are reported for pelvic sidewall recurrences which traditionally are associated with a particularly poor prognosis.
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Contraceptive Knowledge and Use:
A Survey of New Delhi Women
Suneeta Mittal (Professor)
P. N. Anandalakshmy (Additional Professor)
M. Lakhatia (Research Officer)
Department of Obstetrics and Gynaecology*, Department of Statistics and Demography**, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
Summary
- Two thousand women of reproductive age were interviewed regarding their contraceptive behaviour.
- Of the married women participating in the survey, very few used any form of contraception for the first 2 years of marriage, or immediately postpartum.
- However, the majority (99%) agreed that spacing of children was essential; 55% believed that the ideal time interval between children was 3-5 years.
- Only 6% of women taking part were aware of emergency contraception (EC).
- Patient education is the key to overcoming many of the hindrances to EC.
Editor's Comment
This medium-sized survey of contraceptive practices among mainly rural or semi-urban women in the North of India highlights a lack of awareness of EC and, consequently, the need to impart greater information on this subject. This being the case, the present opportunity is taken to discuss in more detail EC and its role.
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