J Korean Cancer Assoc.
2000 Aug;32(4):705-713.
The Inefficiency of Routine Performance of a Batch of Tests
in the Clinical Staging Work-up of Cervical Carcinoma
- Affiliations
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- 1Department of Obstetrics and Gynecology and Clinical Research Institute,
Seoul National University Hospital, Seoul, Korea.
Abstract
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PURPOSE: This study was to evaluate the efficiency of routine performance of a batch of tests
in the clinical staging work-up of cervical carcinoma.
MATERIALS AND METHODS
The medical records were reviewed for 1,393 consecutive cervical
carcinoma patients who underwent pretreatment staging work-up in Seoul National University
Hospital from January 1988 to December 1997. The impression stage -which is designated ten
tatively by the findings of pelvic examination and biopsy-, the results of staging work-up, and
the finally allotted FIGO clinical stage were reviewed. The annual trend of stage distribution
and the positive yields of tests were evaluated.
RESULTS
Annual trend shows that Ia is increasing. The positive yield of chest x-ray was 0.22%
(3/1, 379; Ib: 1, IIa: 1, IIb: 1), intravenous pyelography (IVP) 2.50% (31/1, 242; Ib: 2, IIa: 4,
IIb: 17, IIIb: 8), cystoscopy 0.55% (6/1, 093; IIb: 4, IIIb: 2), and proctosigmoidoscopy 0.086%
(1/1, 157; Ib: 1). After completing the staging work-up, 29 patients (2.08%) were upstaged. The
routine performance of IVP in impression stage Ia and cystoscopy in impression stage IIa or
less was considered inefficient. The routine performance of proctosigmoidoscopy was considered
inefficient because of its very low yield.
CONCLUSION
The selective performance of tests according to the impression stage during staging
work-up is recommended to minimize the unnecessary treatment delay, cost, and patients'
discomfort.