Evaluating the impact of restored nonverbal communication on medical service quality and patient loyalty in the post-pandemic era.

Cervical cancer is a global health issue that seriously affects women (–). According to the World Health Organization (WHO), cervical cancer is the most common cancer among women in 23 countries and the leading cause of cancer-related deaths in 36 countries (). Early-stage cervical cancer accounts for approximately 72.7% of cases, with a five-year survival rate of over 90% (, ). However, locally advanced cervical cancer (LACC) comprises 37% of cases, with a total five-year survival rate varying between 24.0% and 76.1% (). Despite recent advancements in treatment strategies, platinum-based concurrent chemoradiotherapy remains the standard treatment for many patients with LACC. However, treatment outcomes vary substantially according to tumor stage, tumor burden, lymph-node status, and treatment strategy, and recurrence remains an important clinical concern in selected patients (). In addition, 23.3%–34.4% of patients experience tumor recurrence or metastasis after treatment (). As a result, optimizing treatment strategies for selected patients with LACC remains a major challenge for gynecologic oncologists (). LACC can be categorized into broad and narrow definitions. The broader definition includes cervical cancer stages IB3 to IVA according to FIGO 2018 staging, while the narrower definition specifically includes stages IB3 and IIA2 (). Both definitions are characterized by a local tumor diameter greater than 4 cm, without reaching the pelvic wall or distal vagina ().