Effect of changes in treatment practice on survival for cervical cancer: results from a population-based study in Manitoba, Canada

Table 1 Synthesised guidelines for treatment of cervical cancer cases

	Recommended treatment
FIGO stage	Consensus guidelines^a [12, 19] (applicable to 1998)	Synthesised evidence-based guidelines [4–7, 11] (applicable from 1999 onwards)
IA1	Total hysterectomy, conisation, radical hysterectomy^b, radiotherapy^c	Total hysterectomy, conisation, radiotherapy
IA2	Radical hysterectomy, total hysterectomy, radiotherapy^c	Radical hysterectomy, total hysterectomy^d, trachelectomy, radiotherapy^c
IB-IIA
≤4 cm	Radical hysterectomy, radiotherapy	Radical hysterectomy, radiotherapy,
≤4 cm	Radical hysterectomy, radiotherapy	Radical hysterectomy + adjuvant radiotherapy (chemo-radiotherapy)
>4 cm	Radical hysterectomy, radical hysterectomy + adjuvant radiotherapy	Radical hysterectomy, chemo-radiotherapy,
>4 cm		Radical hysterectomy + adjuvant radiotherapy(chemo-radiotherapy)
IIB-IVA	Chemo-radiotherapy, radiotherapy	Chemo-radiotherapy
IVB	Radiotherapy (curative/palliative), chemotherapy	Radiotherapy (curative/palliative), chemotherapy, chemo-radiotherapy

^aDevelopment of consensus guidelines is a long process and we assumed that the evidence supporting the decision was available before the guidelines were published. Therefore, we measured concordance up to 1998 based on consensus guidelines published up to 2000
^bRadical hysterectomy was used if there was lymph-vascular permeation on the cone biopsy
^cRadiotherapy was used if medically inoperable
^dTotal hysterectomy was used if there was no lympho-vascular permeation on the cone biopsy

ISSN: 1471-2407