Surgical Treatment Of Cervical Cancer Research Articles

Robot-assisted Müllerian compartment resection for cervical cancer.

Radical hysterectomy has been established as the standard treatment for early stage cervical cancers. Despite numerous efforts to standardize the technique for radical hysterectomy across varying extents of tumor invasion, success has been inconsistent. Total Müllerian Compartment Resection (TMCR), an ontogenetic compartment-based oncologic surgery initially developed for open procedures by Professor Höckel, offers a standardized approach applicable to all patients with locally confined tumors. This method holds promise for achieving thorough oncologic clearance while maintaining acceptable complication rates. Moreover, robotic-assisted surgery may further reduce morbidity compared to open surgery. In this context, we provide a detailed step-by-step description of robotically assisted Total Müllerian Compartment resection (R-TMCR) for cervical cancer and present feasibility data from a cohort of 20 patients. 20 patients with stage IA1-IB2 cervical cancer, robot-assisted resection of the Müllerian embryonic compartment was undertaken. Key metrics such as operative duration, intraoperative blood loss, and postoperative complication rates were meticulously recorded and analyzed. The duration of the surgery varied from 185 to 500 minutes, with intraoperative blood loss ranging between 5 mL and 300 mL. Postoperative hemoglobin levels dropped by -15 to 40 g/L from their preoperative values. Notably, there were no instances necessitating conversion to open surgery, and no intraoperative complications occurred. The rate of postoperative complications was 0%. Over the follow-up period, which averaged 18 months, there were no observed locoregional recurrences of cervical cancer, nor were there any deaths attributed to cervical cancer during this time. The application of robotic Müllerian compartment resection in the surgical treatment of cervical cancer is both safe and feasible. Utilizing robotic technology enables more precise and refined surgical outcomes. Combining embryonic compartment-based radical hysterectomy with the principles of membrane anatomy can standardize and optimize the surgical process, helping surgeons master radical hysterectomy more quickly and effectively.

Impact of postsurgical vaginal microbiome on high-risk HPV infection and recurrence risk in patients with cervical cancer and intraepithelial neoplasia: A retrospective study

PurposeThis study aimed to determine the effect of postsurgical vaginal microbiome (VM) on high-risk human papillomavirus (hrHPV) infection and the risk of disease recurrence in patients surgically treated for cervical cancer (CC) or intraepithelial neoplasia (CIN). Methods207 women who underwent surgical treatment for CC or CIN at the Department of Gynecologic Oncology of the First Affiliated Hospital of University of Science and Technology of China from November 2016 to October 2023 were included. The patients’ clinical data, including age, surgical modality, and diagnosis at time of index surgery, were collected retrospectively and analyzed. Associations between postsurgical VM indices, hrHPV infection, cervical cytology, and recurrence were also evaluated. ResultsPatient age, surgical modality (whether complete excision of the cervix was performed), and diagnosis at time of index surgery (cervical dysplasia vs. cervical carcinoma) showed no significant association with postsurgical hrHPV infection, cervical cytology, or disease recurrence. However, postsurgical VM imbalance was significantly associated with hrHPV infection status (OR = 4.640, 95 % CI = 2.085–10.460, P < 0.001), abnormal cervical cytology (OR = 3.994, 95 % CI = 1.154–13.826, P = 0.020), and disease recurrence (OR = 3.789, 95 % CI = 1.091–13.154, P = 0.026). Among the specific VM indices, a vaginal pH above 4.5 (OR = 4.570, 95 % CI = 1.640–12.690, P = 0.002), a lactobacilli proportion below 50 % (OR = 3.938, 95 % CI = 1.299–11.934, P = 0.010), and the presence of aerobic vaginitis (AV, OR = 2.425, 95 % CI = 0.996–5.901, P = 0.046) were risk factors for postsurgical recurrence. ConclusionPostsurgical VM imbalance, especially abnormal indices, such as a pH above 4.5, a lactobacilli proportion below 50 %, and the presence of AV, was associated with an increased risk of postsurgical recurrence in patients who underwent surgical treatment for CIN and CC. Monitoring and potentially intervening in the VM may improve the prognosis of these patients.

A SQUAMOUS CELL CARCINOMA OF THE UTERINE CERVIX RECURRING IN THE FORM OF AN ISOLATED BLADDER METASTASIS: A CASE REPORT AND REVIEW OF THE LITERATURE

Bladder cancer is the second most common urological cancer after prostate cancer, and bladder metastases are rare. We report the case of a 42-year-old female patient who underwent surgical treatment for cervical cancer 5 years ago and presented with a recurrence of her disease in the form of an isolated bladder tumor resembling primary bladder cancer. The diagnosis was confirmed by human papillomavirus (HPV) genotyping performed on the biopsy sample of the bladder tumor. The patient was treated with chemotherapy similar to that used for cervical cancer, with a favorable clinical and biological response.

Controversies and Advances in the Personalized Surgical Treatment of Cervical Cancer.

Cervical cancer represents a global health issue as it is mostly encountered in women of reproductive age, while at the same time, survival outcomes seem to have remained constant during the last two decades. The need to implement fertility-sparing strategies as well as to decrease the morbidity that accompanies radical treatment has been extensively studied. During the last decade, several randomized clinical trials have been released, resulting in significant advances in the surgical treatment of early-stage disease. At the same time, evidence about the surgical treatment of advanced-stage disease as well as recurrent disease has gradually appeared and seems to be promising, thus leading the point forward towards personalized medicine that will remove the surgical barriers that seem concrete in our era. Nevertheless, the discrepancies in perioperative morbidity and survival outcomes that were observed among published studies raise several questions. In the present article, we chose to review the gray fields in the surgical treatment of early-stage and advanced-stage cervical cancer. Studies that are based on strong evidence that support current clinical practice are compared to smaller cohorts that present novel data that may form the basis for future research, and issues that remain poorly explored are discussed in an effort to help establish a consensus for future research development.

VNOTES Radical Hysterectomy: A New Approach to Cervical Cancer

To demonstrate how a radical hysterectomy with sentinel node resection for cervical cancer can be performed via vaginal Natural Orifice Transluminal Endoscopic Surgery (vNOTES). Demonstration of the technique in 10 steps. making use of narrated original video footage SETTING: The surgical treatment of cervical cancer is traditionally performed via one of the following techniques: Wertheim radical hysterectomy via laparotomy, Schauta radical hysterectomy vaginally, laparoscopic radical hysterectomy or robotic radical hysterectomy. The results of the LACC trial showed that minimally invasive radical hysterectomy was associated with lower rates of disease-free survival and overall survival than open radical hysterectomy among women with early-stage cervical Cancer [1]. For endometrial cancer, a vNOTES retroperitoneal approach to sentinel node resection was first published in 2019 [2]. Based on the experience with this approach and with Schauta-Stoeckel radical hysterectomy for cervical cancer [3], a new approach was developed to perform a radical hysterectomy via vNOTES whereby most of the procedure is performed retroperitoneally [4]. This video article demonstrates in 10 steps how a radical hysterectomy via vNOTES is performed. Radical hysterectomy via vNOTES demonstrated making use of original video footage of a 57-year-old woman operated on for cervical adenocarcinoma 7 weeks after a LEEP cone. The steps of the procedure are: 1. Vaginal cuff creation, 2. Development of lateral retroperitoneal space and sentinel node resection, 3. Uterine artery and vein transection, 4. Hypogastric nerve dissection, 5. Development of central retroperitoneal space and rectum dissection, 6. Posterior colpotomy, 7. Parametrium dissection, 8. Bladder pillar dissection, 9. Anterior colpotomy, 10. Salpingo-oophorectomy or salpingectomy. 3 Patients were so far treated by this new technique that allowed for good hemostatic control. vNOTES enables a potentially less invasive approach to radical hysterectomy performed largely retroperitoneally and completely transvaginally, leaving no visible scars. The endoscopic approach offers excellent visualization of the retroperitoneal and parametrial anatomy. This is a new approach that requires further validation and should only be performed in a research setting, taking into account the current reservations about endoscopic surgery for cervical cancer resulting from the LACC trial. VIDEO ABSTRACT.

Radical Hysterectomy or Total Mesometrial Resection-Two Anatomical Concepts for Surgical Treatment of Cancer of the Uterine Cervix.

A radical hysterectomy is the standard method of surgical treatment for patients with early-stage cancer of the uterine cervix. It was first introduced more than 100 years ago. Since then, various and many different radical procedures, which diverge in terms of radicality, have been described. Inconsistencies are clearly seen in practical anatomy, which were defined as surgically created artifacts. Moreover, the disparity of the procedure is most notable regarding the terminology of pelvic connective tissues and spaces. Despite these controversies, the procedure is widely performed and implemented in the majority of guidelines for the surgical treatment of cancer of the uterine cervix. However, a different and unique concept of surgical treatment of cervical cancer has been reported. It is based on ontogenetic anatomy and maps any tissue in the mature organism according to its embryologic development. The clinical implementation of this theory in the context of early cervical cancer is total mesometrial resection. The present article aims to describe and compare the anatomical and surgical basics of a radical hysterectomy (type C1/C2) and total mesometrial resection. Discrepancies regarding the terminology, resection lines, and surgical planes of both procedures are highlighted in detail. The surgical anatomy of the pelvic autonomic nerves and its surgical dissection is also delineated. This is the first article that compares the discrepancy of classic anatomy and ontogenic anatomy regarding surgical treatment of cancer of the uterine cervix. Clinical data, oncological outcome, and neoadjuvant and adjuvant treatment regarding both procedures are not the topic of the present article.

Desmoplasia in cervical cancer is associated with a more aggressive tumor phenotype

In cancer of the uterine cervix, the role of desmoplasia, i.e., peritumoral stromal remodeling characterized by fibroblast activation and increased extracellular matrix deposition, is not established. We conducted a retrospective cohort study based on data from 438 patients who had undergone surgical treatment for cervical cancer as part of the prospective Leipzig Mesometrial Resection study between 1999 and 2021. Using non-parametric tests, Kaplan–Meier plotting, and Cox regression modeling, we calculated the prognostic impact of desmoplasia and its association with other risk factors. Desmoplasia was present in 80.6% of cases and was associated with a higher frequency of lymphovascular space involvement (76.5 vs. 56.5%, p < 0.001) and venous infiltration (14.4 vs. 2.4%, p < 0.001). Lymph node metastasis (23.0 vs. 11.8%, p < 0.05) and parametrial involvement (47.3 vs. 17.6%, p < 0.0001) were also more common in patients with desmoplasia. The presence of desmoplasia was associated with inferior overall (80.2% vs. 94.5% hazard ratio [HR] 3.8 [95% CI 1.4–10.4], p = 0.002) and recurrence-free survival (75.3% vs. 87.3%, HR 2.3 [95% CI 1.2–4.6], p = 0.008). In addition, desmoplasia was associated with significantly less peritumoral inflammation (rho − 0.43, p < 0.0001). In summary, we link desmoplasia to a more aggressive phenotype of cervical cancer, reduced peritumoral inflammation, and inferior survival.

Repere anatomice în histerectomia radicală

Introduction. Customizing surgical radicality is a crucial element in contemporary cervical cancer surgery. Currently, anatomic structures are characterized based on many anatomic interpretations. In order to suggest its general applicability, this study proposes to standardize the definitions and anatomic landmarks of the various types of radical hysterectomy. Methodology. This paper is a literature review in which we selected relevant articles from PubMed database, starting with the year of publication 2010 until 2023, using the following keywords: “cervical cancer”, “radical hysterectomy”, “classification of radical hysterectomy”, “anatomic landmarks”, “tailoring surgery”, “nerve-sparing procedure”. Results. The lateral extent of resection serves as the basis for the updated Querleu-Morrow classification. The three-dimensional anatomic template used to define the resection limits is based on the precise anatomy of the paracolpium and parametrium. The main anatomic landmarks and avascular spaces of the pelvis serve as the basis for the oncologic procedures, including nerve-sparing techniques. There are four different types of radical hysterectomy, each type described with three-dimensional landmarks. There are three main objectives that never change: excising the central tumor with clear margins, removal of any possible lymph dissemination sites, and the control of metastatic disease. Conclusions. It is essential to base research evaluating radicality in the surgical treatment of cervical cancer on precise and generally accepted nomenclature and descriptions. Since the degree of parametrium excision affects late morbidity, particularly bladder and rectal dysfunctions, the thorough explanation and understanding of the many forms of radical hysterectomy are crucial.

ESGO/ESTRO quality indicators for radiation therapy of cervical cancer

BackgroundThe European Society of Gynaecological Oncology (ESGO) has previously defined and established a list of quality indicators for the surgical treatment of cervical cancer. As a continuation of this effort to improve overall quality of care for cervical cancer patients across all aspects, ESGO and the European SocieTy for Radiotherapy and Oncology (ESTRO) initiated the development of quality indicators for radiation therapy of cervical cancer. ObjectiveTo develop a list of quality indicators for radiation therapy of cervical cancer that can be used to audit and improve clinical practice by giving to practitioners and administrators a quantitative basis to improve care and organizational processes, notably for recognition of the increased complexity of modern external radiotherapy and brachytherapy techniques. MethodsQuality indicators were based on scientific evidence and/or expert consensus. The development process included a systematic literature search for identification of potential quality indicators and documentation of scientific evidence, consensus meetings of a group of international experts, an internal validation process, and external review by a large international panel of clinicians (n = 99). ResultsUsing a structured format, each quality indicator has a description specifying what the indicator is measuring. Measurability specifications are detailed to define how the quality indicators will be measured in practice. Targets were also defined for specifying the level which each unit or center should be aiming to achieve. Nineteen structural, process, and outcome indicators were defined. Quality indicators 1–6 are general requirements related to pretreatment workup, time to treatment, upfront radiation therapy, and overall management, including active participation in clinical research and the decision making process within a structured multidisciplinary team. Quality indicators 7–17 are related to treatment indicators. Quality indicators 18 and 19 are related to patient outcomes. DiscussionThis set of quality indicators is a major instrument to standardize the quality of radiation therapy in cervical cancer. A scoring system combining surgical and radiotherapeutic quality indicators will be developed within an envisaged future ESGO accreditation process for the overall management of cervical cancer, in an effort to support institutional and governmental quality assurance programs.

ESGO/ESTRO quality indicators for radiation therapy of cervical cancer

BackgroundThe European Society of Gynaecological Oncology (ESGO) has previously defined and established a list of quality indicators for the surgical treatment of cervical cancer. As a continuation of this effort...

An analysis of deviation from the ESGO quality indicators for surgical treatment of cervical cancer in a large referral center in the Netherlands

An analysis of deviation from the ESGO quality indicators for surgical treatment of cervical cancer in a large referral center in the Netherlands

Classic articles in cervical cancer research : A bibliometric analysis

Background: Analyzing classic articles or research papers that received total citations of 1000 or more has helped study the evolution of research trends and identify research gaps and future directions in a particular field. This study used a bibliometric approach to analyzing classic articles in cervical cancer research. Method: Classic articles in cervical cancer research with 1,000 or more citations from the Web of Science Core Collection from publication to the end of 2020 were analyzed using bibliometric analysis. These methods determine the document types, most productive countries, institutions, and journals for classic articles in cervical cancer research. Moreover, it also determined their research impact through the years by analyzing their citation histories. Result: We documented 46 classic cervical cancer research papers published in the Web of Science from 1983 until 2019. The CA-A Cancer Journal for Clinicians and the New England Journal of Medicine were the most productive journals that published seven classic cervical cancer articles. The USA was the most productive country, with 28 classic cervical cancer articles. The International Agency for Research on Cancer in France and the American Cancer Society in the USA were the most effective and impactful institutions in cervical cancer research. Citation histories revealed that the most important and cited papers in recent years were cancer statistics that report incidence and mortality from cervical cancer worldwide. The most impactful studies include articles on HPV as a necessary cause of cervical cancer, the discovery and development of HPV vaccines to prevent cervical cancer, and the development of chemotherapy, radiotherapy, and surgical treatment for cervical cancer. Conclusion: This study showed cervical cancer research’s most productive countries, institutions, and journals. It also demonstrated the citation history of these classic articles, which showed influential studies still relevant to cervical cancer research until recently.

XENON-OXYGEN THERAPY AS A FACTOR OF NORMALIZATION OF ADAPTIVE AND PSYCHO-EMOTIONAL STATUS IN PATIENTS DIAGNOSED WITH CERVICAL CANCER AT THE SURGICAL STAGE OF ANTITUMOR TREATMENT

Introduction. Radical surgical treatment of cervical cancer (CC) involves the removal of the uterus with suspected metastatic foci in the regional lymphatic collectors and the ovaries. In this case, total ovarian suppression in patients of reproductive age is accompanied by polysystemic functional disorders in the form of postovariectomy syndrome (POES), which is manifested by changes in homeostasis, neuroendocrine and cardiovascular insufficiency, pronounced disorders in the psychoemotional sphere with the formation of a persistent stress situation and the development of psychological dysfunction.

SUCCOR quality: validation of ESGO quality indicators for surgical treatment of cervical cancer

ObjectiveTo evaluate whether compliance with European Society of Gynaecological Oncology (ESGO) surgery quality indicators impacts disease-free survival in patients undergoing radical hysterectomy for cervical cancer.MethodsIn this retrospective cohort study, 15...

Factors Influencing Lower Limb Lymphedema After Cervical Cancer Surgery: A Case-Control Study.

Background: To analyze the factors influencing lower limb lymphedema (LLL) after cervical cancer surgery and provide a scientific reference for its effective prevention and control. Methods and Results: Patients at a tertiary tumor hospital between January 2010 and January 2020 who received surgical treatment for cervical cancer were included in this study. Patients were divided into lymphedema case group (n = 253) and control group (n = 506) according to lymphedema occurrence, and univariate and multivariate analyses were used to analyze the factors influencing the occurrence of LLL after cervical cancer surgery. Multifactor conditional logistic regression analysis revealed that risk factors for lymphedema occurrence included body mass index, level of education, the presence of preoperative radiotherapy and chemotherapy, radiotherapy within 3 months after postoperative chemoradiotherapy, emergence of coronary heart disease within 3 months, vaginal disease, occurrence of postoperative complications, cervical cancer diagnosis before the manifestation of menstrual abnormalities, and a history of previous surgery. Conclusion: Postoperative LLL after cervical cancer surgery is a chronic progressive disease, and no cure for LLL has been identified. Thus, determining the risk factors associated with LLL occurrence after uterine and cervical cancer surgery and the development of targeted prevention and early intervention strategies is urgently needed.

The effectiveness of mindfulness-based stress reduction intervention on alleviating anxiety and depression in postoperative patients with cervical cancer: A protocol for systematic review and meta-analysis.

Background:Surgical treatment for cervical cancer, as a stressor, largely leads to strong psychological reactions to stress like anxiety and depression. Whether mindfulness-based stress reduction (MBSR) can alleviate anxiety and depression in patients after cervical cancer surgery is controversial. Therefore, we aim to perform a meta-analysis involving randomized controlled trials analyzing the effect of MBSR on alleviating anxiety and depression in patients after cervical cancer surgery, thus providing evidence-based medical evidences for nonpharmacological interventions.Methods:Randomized controlled trials analyzing the effect of MBSR on alleviating anxiety and depression in patients after cervical cancer surgery will be searched in online databases, including Cochrane Central Register of Controlled Trials Repositories, PubMed, Embase, Web of Science, Chinese Science Citation Database, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, Chinese Scientific Journal Database, and Wan Fang Data. After screening eligible studies, we will perform a meta-analysis on the effect of MBSR on alleviating anxiety and depression in patients after cervical cancer surgery.Results:The results of this meta-analysis will be submitted to a peer-reviewed journal for publication.Conclusion:This study will provide reliable evidence-based evidences for the effects of MBSR on alleviating anxiety and depression in patients after cervical cancer surgery.Ethics and dissemination:Ethical approval was not required for this study. The systematic review will be published in a peer-reviewed journal, presented at conferences, and shared on social media platforms.OSF Registration number:DOI 10.17605/OSF.IO/EXUM3.

Manifestation of Urinary Tract Injury during Cervical Cancer Surgery Based on CT Urography Secretion Phase Images.

Methods We grouped the patients who had undergone cervical cancer surgery in a hospital in this article and compared the nanodrug carrier system under CT imaging with traditional laparoscopy. The postoperative physical parameters of surgical patients are collected from cervical cancer patients of different degrees, and the parameters and prognostic health of patients after different operations are compared. Results The results of the study show that the postoperative patient's body parameters of the nanodrug delivery system under the CT imaging technology used in this article are better than those of the traditional surgery group, and the average intraoperative blood loss is about 20% less than that of the traditional surgery. Postoperative complications occur. The situation is even lower, more than 30% lower than traditional surgery. Conclusion This shows that the operation of the nanodrug delivery system based on CT imaging technology has broken through some of the limitations of the development of laparoscopic technology and has played an important role in the surgical treatment of cervical cancer.

Challenges in lower limb lymphoedema assessment based on limb volume change: Lessons learnt from the SENTIX prospective multicentre study

BackgroundLower limb lymphoedema (LLL) is the most disabling adverse effect of surgical staging of pelvic lymph nodes. However, the lack of standardisation of volumetric LLL assessment hinders direct comparison between the studies and makes LLL reporting unreliable. The aim of our study is to report outcomes from a prospective trial that have implications for LLL assessment standardisation. MethodsIn the prospective international multicentre trial SENTIX, a group of 150 patients with stage IA1–IB2 cervical cancer treated by uterine surgery with bilateral sentinel lymph node biopsy was prospectively evaluated by objective LLL assessment, based on limb volume change (LVC) using circumferrential limb measurements and subjective patient-reported swelling. The assessments were conducted in six-month periods over 24 months post-surgery. ResultsPatient LVC substantially fluctuated in both positive and negative directions, which were comparable in frequency up to ±14% change. Thirty-eight patients experienced persistent LVC increase >10% classified as LLL, with nine months median time to onset. Some 34.2% of cases experienced onset later than one year after the surgery. Thirty-three patients (22%) experienced transient oedema characterised as LVC >10%, which resolved without intervention between two consequent follow-up visits. No significant correlation between LVC >10% and a patient-reported swelling was observed. ConclusionsGiven that we observed comparable fluctuations of the the lower-limb volumes after surgical treatment of cervical cancer in both positive and negative direction up to ±14%, the diagnostic threshold for LLL diagnosis based on LVC should be increased to >15% LVC. The distinction of transient oedema from persistent LLL requires repeated measurements. Also, as one-third of LLL cases are diagnosed >1-year post-surgery, a sufficient follow-up duration needs to be ensured. Patient-reported swelling correlated poorly with LVC and should only be used as an adjunct to objective LLL assessment.Trial registration: ClinicalTrials.gov: NCT02494063

Challenges and Controversies in the Surgical Treatment of Cervical Cancer: Open Radical Hysterectomy versus Minimally Invasive Radical Hysterectomy.

Objective: The aim of the study was to perform a systematic assessment of disease-free survival (DFS), overall survival, and morbidity rates after open radical hysterectomy (ORH) and minimally invasive surgery (MIS) for early-stage cervical cancer and discuss with experts the consequences of the LACC trial (published by Ramirez et al. in 2018) on clinical routine. Methods: A total of 5428 records were retrieved. After exclusion based on text screening, four records were identified for inclusion. Five experts from three independent large-volume medical centers in Europe were interviewed for their interpretation of the LACC trial. Results: The LACC trial showed a significantly higher risk of disease progression with MIS compared to ORH (HR 3.74, 95% CI 1.63 to 8.58). This was not seen in one epidemiological study and was contradicted by one prospective cohort study reported by Greggi et al. A systematic review by Zhang et al. mentioned a similar DFS for robot-assisted radical hysterectomy (RRH) and LRH. Recurrence rates were significantly higher with MIS compared to ORH in the LACC trial (HR 4.26, 95% CI 1.44 to 12.60). In contrast, four studies presented by Greggi reported no significant difference in recurrence rates between LRH/RRH and ORH, which concurred with the systematic reviews of Zhang and Zhao. The experts mentioned various limitations of the LACC trial and stated that clinicians were obliged to provide patients with detailed information and ensure a shared decision-making process. Conclusions: The surgical treatment of early-stage cervical cancer remains a debated issue. More randomized controlled trials (RCT) will be needed to establish the most suitable treatment for this condition.

The prevalence of depressive disorder and its association in Thai cervical cancer patients.

The purpose of this study is to examine the prevalence, associated factors and quality of life associated with depressive disorder in cervical cancer patients. This cross-sectional study was carried out in a gynecologic oncology clinic of a university hospital in Northern Thailand from October 2018 to August 2019. Two-hundred cervical cancer patients were screened for depressive disorder using the nine-item Patient Health Questionnaire (PHQ-9), and psychiatrists interviewed eligible patients to confirm diagnoses. We measured the quality of life using questionnaires from the European Organisation for the Research and Treatment of Cancer: Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) and Cervical Cancer Module 24 (EORTC QLQ-Cx24). Associated factors, including comorbidity, fatigue, and pain, were collected using the Charlson Comorbidity Index (CCI), the eleven-item Chalder Fatigue Scale (CFQ 11), and the visual analog scale (VAS) for pain, respectively. Twenty-seven (13.5%) cervical cancer patients were diagnosed with depressive disorder by psychiatrists according to the DSM-5. Depressive disorder was related to a worse quality of life in these patients. A binary logistic regression analysis revealed that depressive disorder among these patients was linked with these factors: high fatigue score (aOR: 1.35; CI: 1.18-1.53), high pain score (aOR: 1.25; CI: 1.02-1.54), no perception of social support, (aOR: 3.12; CI: 1.11-8.81), and no previous surgical treatment for cervical cancer (aOR: 2.99; CI: 1.08-8.29). The depressive disorder prevalence was 13.5% in Northern Thai cervical cancer patients. In this demographic, cervical cancer patients-who reported high fatigue or pain scores, did not perceive social support, or had no previous cervical cancer surgery- were more likely to have depressive disorder.