Metastatic Disease Patterns of Uterine Cervical Cancer on Computed Tomography at an Oncology Hospital in Cameroon: A Pilot Study

Abstract

Close to three-quarters (70%) of all cases of cervical cancer occur in countries with a low human development index where the burden of infections with human papilloma virus is high and screening uptake is low. The aim of this study was to assess the burden of metastatic disease from cervical cancer and the pattern of spread in a sub-Saharan African population. We extracted data from reports of computed tomography scans of the thorax, abdomen and pelvis (CT-TAP) of patients with histologically proven cervical cancer from a prospectively collected cancer imaging database from July 2022 to February 2024. Independent statistical associations were performed using Fisher’s exact test whilst metastatic disease patterns were illustrated with a Sankey diagram. Data was extracted from 113 CT-TAP reports of patients. The mean age was 59.9 ± 12.21 (range: 38 to 84 years). There was reported local, regional or distant spread in 53 out of 103 (46.39%) patients. Four out of 8 (50.00%) baseline scans for staging reported tumor spread, against 49 out of 105 (46.67%) follow-up scans (p=0.570). Cancer spread was mostly local invasion than distant (59% vs. 41%). Parametrial invasion was reported in 41 cases (35.04%), followed by nodal tumor disease (32 cases; 27.35%) of which 75% was pelvic. Common sites for distant metastatic disease were the peritoneum (16 cases; 13.68%), spleen (12 cases; 10.26%) and pleurae (12 cases; 10.26%). Age-related trends in the occurrence of metastatic disease was significant with a peak at 40 to 49 years (p=0.001). The high burden of cervical cancer spread suggests the need to intensify primordial, primary and secondary prevention strategies.