Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-8448b6f56d-mp689 Total loading time: 0 Render date: 2024-04-23T19:47:20.274Z Has data issue: false hasContentIssue false

Chapter 34 - Clinical Management of Cervix Cancer

from Section 7 - Cervix

Published online by Cambridge University Press:  24 November 2021

By
Eric Leblanc ,
Fabrice Narducci ,
Delphine Hudry ,
Abel Cordoba ,
Florence Le Tinier ,
Annick Chevalier ,
Cyril Abdeddaim ,
Valerie Chevalier-Evain ,
Charlotte Bellier  and
Emilie Kaczmarek
...Show all authors
Edited by
Tahir Mahmood ,
Charles Savona-Ventura ,
Ioannis Messinis  and
Sambit Mukhopadhyay
Tahir Mahmood
Affiliation:
Victoria Hospital, Kirkcaldy
Charles Savona-Ventura
Affiliation:
University of Malta, Malta
Ioannis Messinis
Affiliation:
University of Thessaly, Greece
Sambit Mukhopadhyay
Affiliation:
Norfolk & Norwich University Hospital, UK
Get access

Summary

Cervical cancer is the fourth most common cancer of women, with a wide range of variation of incidence across the globe. It continues to be a major public health problem particularly in countries with poorly resourced healthcare. Persistent infection with high-risk HPV and ineffective clearance of HPV are central to causation of cellular changes at the squamocolumnar junction, leading to the development of invasive cancer. A global initiative of preventative vaccination, screening and treatment has developed to eradicate cervical cancer as a public health problem. Diagnosis of early invasive cancer is seen in well-established screening programmes. This chapter reviews the management of early invasive and recurrent cervical cancer.

Keywords

cervical cancercervixintraepithelialhysterectomyfertility preservation
Type
Chapter
Information
The EBCOG Postgraduate Textbook of Obstetrics & Gynaecology
Gynaecology
 , pp. 284 - 292
Publisher: Cambridge University Press
Print publication year: 2021

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bray, F, Ferlay, J, Soerjomataram, I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018. doi:10.3322/caac.21492.CrossRefGoogle Scholar
Bhatla, N, Aoki, D, Sharma, DN, Sankaranarayanan, R. Cancer of the cervix uteri. Int J Gynaecol Obstet Off Organ Int Fed Gynaecol Obstet 2018;143(Suppl 2):22–36.Google Scholar
Cheng-Yen Lai, J, Yang, M-S, Lu, K-W, et al. The role of sentinel lymph node biopsy in early-stage cervical cancer: a systematic review. Taiwan J Obstet Gynecol 2018;57:627–635.Google Scholar
Cibula, D, Pötter, R, Planchamp, F, et al. The European Society of Gynaecological Oncology/European Society for Radiotherapy and Oncology/European Society of Pathology guidelines for the management of patients with cervical cancer. Int J Gynecol Cancer Off J Int Gynecol Cancer Soc 2018;28:641–655.CrossRefGoogle ScholarPubMed
Leblanc, E, Katdare, N, Narducci, F, et al. Should systematic infrarenal para-aortic dissection be the rule in the pretherapeutic staging of primary or recurrent locally advanced cervix cancer patients with a negative preoperative para-aortic PET imaging? Int J Gynecol Cancer Off J Int Gynecol Cancer Soc 2016;26:169–175.CrossRefGoogle ScholarPubMed
Querleu, D, Cibula, D, Abu-Rustum, NR. 2017 update on the Querleu-Morrow classification of radical hysterectomy. Ann Surg Oncol 2017;24:3406–3412.Google Scholar
Deli, T, Orosz, M, Jakab, A. Hormone replacement therapy in cancer survivors – review of the literature. Pathol Oncol Res 2019;26:63–78.CrossRefGoogle ScholarPubMed
van Gent, MDJM, Romijn, LM, van Santen, KE, Trimbos, JBMZ, de Kroon, CD. Nerve-sparing radical hysterectomy versus conventional radical hysterectomy in early-stage cervical cancer. A systematic review and meta-analysis of survival and quality of life. Maturitas 2016;94:30–38.CrossRefGoogle ScholarPubMed
Wang, Y, Deng, L, Xu, H, Zhang, Y, Liang, Z. Laparoscopy versus laparotomy for the management of early stage cervical cancer. BMC Cancer 2015;24:928.CrossRefGoogle Scholar
Zanagnolo, V, Garbi, A, Achilarre, MT, Minig, L. Robot-assisted surgery in gynecologic cancers. J Minim Invasive Gynecol 2017;24:379–396.CrossRefGoogle ScholarPubMed
Ramirez, PT, Frumovitz, M, Pareja, R, et al. Minimally invasive versus abdominal radical hysterectomy for cervical cancer. N Engl J Med 2018;379:1895–1904.CrossRefGoogle ScholarPubMed
ESGO. Laparoscopic radical hysterectomy: an ESGO statement. Available at: www.esgo.org/explore/council/laparoscopic-radical-hysterectomy-an-esgo-statement.Google Scholar
Anon. Minimally invasive or abdominal radical hysterectomy for cervical cancer. N Engl J Med 2019;380:793–795.CrossRefGoogle Scholar
Leblanc, E. [How I perform … vaginal preparation for a laparoscopic radical hysterectomy or the ‘Schautheim’ procedure]. Gynecol Obstet Fertil 2007;35:263–264.CrossRefGoogle ScholarPubMed
Kohler, C, Hertel, H, Herrmann, J, et al. Laparoscopic radical hysterectomy with transvaginal closure of vaginal cuff: a multicenter analysis. Int J Gynecol Cancer Off J Int Gynecol Cancer Soc 2019;29:845–850.Google Scholar
Querleu, D, Leblanc, E. Combined vaginal and laparoscopic approach for the surgical management of cervical cancer: a historic note. Int J Gynecol Cancer Off J Int Gynecol Cancer Soc 2019;29:1228–1229.CrossRefGoogle ScholarPubMed
Chiva, L, Study, S. An international European cohort observational study comparing minimally invasive surgery versus open abdominal radical hysterectomy in patients with stage IB1 cervical cancer operated in 2013–2014. 21st Congress of the European Society of Gynaecologic Oncology, Athens, Greece, 2019.Google Scholar
Lin, F, Pan, L, Li, L, Li, D, Mo, L. Effects of a simulated CO2 pneumoperitoneum environment on the proliferation, apoptosis, and metastasis of cervical cancer cells in vitro. Med Sci Monit Int Med J Exp Clin Res 2014;20:2497–2503.Google Scholar
Chao, X, Li, L, Wu, M, et al. Efficacy of different surgical approaches in the clinical and survival outcomes of patients with early-stage cervical cancer: protocol of a phase III multicentre randomised controlled trial in China. BMJ Open 2019;9:e029055.Google Scholar
Doll, KM, Donnelly, E, Helenowski, I, et al. Radical hysterectomy compared with primary radiation for treatment of stage IB1 cervix cancer. Am J Clin Oncol 2014;37:30–34.Google Scholar
Yang, J, Yin, J, Yan, G, Huang, D, Wang, J. Postoperative chemoradiotherapy versus radiotherapy alone for cervical cancer: a systematic review and meta-analysis. J Obstet Gynaecol J Inst Obstet Gynaecol 2016;36:641–648.CrossRefGoogle ScholarPubMed
Escande, A, Gouy, S, Mazeron, R, et al. Outcome of early stage cervical cancer patients treated according to a radiosurgical approach: Clinical results and prognostic factors. Gynecol Oncol 2017;144:541–546.Google Scholar
Vízkeleti, J, Vereczkey, I, Fröhlich, G, et al. Pathologic complete remission after preoperative high-dose-rate brachytherapy in patients with operable cervical cancer: preliminary results of a prospective randomized multicenter study. Pathol Oncol Res POR 2015;21:247–256.CrossRefGoogle ScholarPubMed
Bentivegna, E, Maulard, A, Pautier, P, et al. Fertility results and pregnancy outcomes after conservative treatment of cervical cancer: a systematic review of the literature. Fertil Steril 2016;106:1195–1211.e5.Google Scholar
Bentivegna, E, Gouy, S, Maulard, A, et al. Oncological outcomes after fertility-sparing surgery for cervical cancer: a systematic review. Lancet Oncol 2016;17:e240–e253.Google Scholar
Plante, M. Bulky early-stage cervical cancer (2–4 cm lesions): upfront radical trachelectomy or neoadjuvant chemotherapy followed by fertility-preserving surgery: which is the best option? Int J Gynecol Cancer Off J Int Gynecol Cancer Soc 2015;25:722–728.Google Scholar
Fischerová, D, Cibula, D. The role of ultrasound in primary workup of cervical cancer staging (ESGO, ESTRO, ESP cervical cancer guidelines). Ceska Gynekol 2019;84:40–48.Google Scholar
Gouy, S, Morice, P, Narducci, F, et al. Nodal-staging surgery for locally advanced cervical cancer in the era of PET. Lancet Oncol 2012;13:e212–e220.Google Scholar
Ghezzi, F, Cromi, A, Serati, M, et al. Radiation-induced bowel complications: laparoscopic versus open staging of gynecologic malignancy. Ann Surg Oncol 2011;18:782–791.Google Scholar
Lai, C-H, Huang, K-G, Hong, J-H, et al. Randomized trial of surgical staging (extraperitoneal or laparoscopic) versus clinical staging in locally advanced cervical cancer. Gynecol Oncol 2003;89:160–167.Google Scholar
Green, J, Kirwan, J, Tierney, J, et al. Concomitant chemotherapy and radiation therapy for cancer of the uterine cervix. Cochrane Database Syst Rev 2005;3:CD002225.Google Scholar
Rose, PG, Java, JJ, Whitney, CW, et al. Locally advanced adenocarcinoma and adenosquamous carcinomas of the cervix compared to squamous cell carcinomas of the cervix in gynecologic oncology group trials of cisplatin-based chemoradiation. Gynecol Oncol 2014;135:208–212.Google Scholar
Datta, NR, Stutz, E, Gomez, S, Bodis, S. Efficacy and safety evaluation of the various therapeutic options in locally advanced cervix cancer: a systematic review and network meta-analysis of randomized clinical trials. Int J Radiat Oncol Biol Phys. 2018. doi: 10.1016/j.ijrobp.2018.09.037.Google Scholar
Datta, NR, Stutz, E, Liu, M, et al. Concurrent chemoradiotherapy vs. radiotherapy alone in locally advanced cervix cancer: a systematic review and meta-analysis. Gynecol Oncol 2017;145:374–385.CrossRefGoogle Scholar
Keys, HM, Bundy, BN, Stehman, FB, et al. Radiation therapy with and without extrafascial hysterectomy for bulky stage IB cervical carcinoma: a randomized trial of the Gynecologic Oncology Group. Gynecol Oncol 2003;89:343–353.CrossRefGoogle ScholarPubMed
Mazeron, R, Gouy, S, Chargari, C, et al. Post radiation hysterectomy in locally advanced cervical cancer: outcomes and dosimetric impact. Radiother Oncol J Eur Soc Ther Radiol Oncol 2016;120:460–466.Google Scholar
Kumar, L, Gupta, S. Integrating chemotherapy in the management of cervical cancer: a critical appraisal. Oncology 2016;91(Suppl 1):8–17.Google Scholar
Kim, TH, Kim, M-H, Kim, B-J, et al. Prognostic importance of the site of recurrence in patients with metastatic recurrent cervical cancer. Int J Radiat Oncol Biol Phys 2017;98:1124–1131.CrossRefGoogle ScholarPubMed
Seamon, LG, Java, JJ, Monk, BJ, et al. Impact of tumour histology on survival in advanced cervical carcinoma: an NRG Oncology/Gynaecologic Oncology Group Study. Br J Cancer 2018;118:162–170.Google Scholar
Magrina, JF, Stanhope, CR, Weaver, AL. Pelvic exenterations: supralevator, infralevator, and with vulvectomy. Gynecol Oncol 1997;64:130–135.Google Scholar
Höckel, M. Long-term experience with (laterally) extended endopelvic resection (LEER) in relapsed pelvic malignancies. Curr Oncol Rep 2015;17:435.Google Scholar
Cordeiro, CN, Gemignani, ML. Gynecologic malignancies in pregnancy: balancing fetal risks with oncologic safety. Obstet Gynecol Surv 2017;72:184–193.CrossRefGoogle ScholarPubMed
Hellström, A-C, Hellman, K, Pettersson, BF, Andersson, S. Carcinoma of the cervical stump: fifty years of experience. Oncol Rep 2011;25:1651–1654.Google Scholar
Narducci, F, Merlot, B, Bresson, L, et al. Occult invasive cervical cancer found after inadvertent simple hysterectomy: is the ideal management: systematic parametrectomy with or without radiotherapy or radiotherapy only? Ann Surg Oncol 2015;22:1349–1352.Google Scholar
Yamazaki, H, Todo, Y, Takeshita, S, et al. Relationship between removal of circumflex iliac nodes distal to the external iliac nodes and postoperative lower-extremity lymphedema in uterine cervical cancer. Gynecol Oncol 2015;139:295–299.Google Scholar
Magrina, JF, Goodrich, MA, Weaver, AL, Podratz, KC. Modified radical hysterectomy: morbidity and mortality. Gynecol Oncol 1995;59:277–282.CrossRefGoogle ScholarPubMed
Espino-Strebel, EE, Luna, JTP, Domingo, EJ. A comparison of the feasibility and safety of nerve-sparing radical hysterectomy with the conventional radical hysterectomy. Int J Gynecol Cancer Off J Int Gynecol Cancer Soc 2010;20:1274–1283.Google Scholar
Kim, HS, Kim, M, Luo, Y, Lee, M, Song, YS, FUSION Study Group. Favorable factors for preserving bladder function after nerve-sparing radical hysterectomy: a protocol-based validation study. J Surg Oncol 2017;116:492–499.CrossRefGoogle ScholarPubMed
Koh, V, Choo, BA, Lee, KM, et al. Feasibility study of toxicity outcomes using GEC-ESTRO contouring guidelines on CT based instead of MRI-based planning in locally advanced cervical cancer patients. Brachytherapy 2017;16:126–132.Google Scholar
Papadimitriou, CA, Sarris, K, Moulopoulos, LA, et al. Phase II trial of paclitaxel and cisplatin in metastatic and recurrent carcinoma of the uterine cervix. J Clin Oncol Off J Am Soc Clin Oncol 1999;17:761–766.Google Scholar
Kitagawa, R, Katsumata, N, Shibata, T, et al. Paclitaxel plus carboplatin versus paclitaxel plus cisplatin in metastatic or recurrent cervical cancer: the open-label randomized phase III trial JCOG0505. J Clin Oncol Off J Am Soc Clin Oncol 2015;33:2129–2135.Google Scholar
Tewari, KS, Sill, MW, Penson, RT, et al. Bevacizumab for advanced cervical cancer: final overall survival and adverse event analysis of a randomised, controlled, open-label, phase 3 trial (Gynecologic Oncology Group 240). Lancet Lond Engl 2017;390:1654–1663.Google Scholar
Matsuo, K, Machida, H, Mandelbaum, RS, Konishi, I, Mikami, M. Validation of the 2018 FIGO cervical cancer staing system. Gynecol Oncol 2018;152:87–93.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×