Cervical cancer Flashcards
IA1
stromal invasion <3 mm in depth
IA2
Measured stromal invasion ≥3 mm and <5 mm in depth
IB
Invasive carcinoma with measured deepest invasion ≥5 mm (greater than stage IA), lesion
limited to the cervix uteri
IB1
Invasive carcinoma ≥5 mm depth of stromal invasion and
<2 cm in greatest dimension
IB2
Invasive carcinoma ≥2 cm and <4 cm in greatest dimension
IB3
Invasive carcinoma ≥4 cm in greatest dimension
Stage II
Beyond the uterus, but not to the pelvic wall or to the lower third of the vagina
IIA
Involvement limited to the upper two‐thirds of the vagina without parametrial involvement
IIA1
Invasive carcinoma <4 cm in greatest dimension
IIA2
Invasive carcinoma ≥4 cm in greatest dimension
IIB
With parametrial involvement but not up to the pelvic wall
Stage III
Extends to the pelvic wall and/or involves lower third of the vagina and/or
causes hydronephrosis or non-functioning kidney and/or involves pelvic and/or
paraaortic lymph nodes
IIIA
Carcinoma involves the lower third of the vagina, with no extension to the pelvic wall
IIIB
Extension to the pelvic wall and/or hydronephrosis or non‐ functioning kidney
IIIC
Involvement of pelvic and/or paraaortic lymph nodes, irrespective of tumor size and
extent
IIIC1
Pelvic lymph node metastasis only
IIIC2
Paraaortic lymph node metastasis
Stage IV T
The carcinoma has extended beyond the true pelvis or has involved (biopsy proven)
the mucosa of the bladder or rectum. A bullous edema, as such, does not permit a case to be
allotted to stage IV
IVA
Spread of the growth to adjacent organs
IVB
Spread to distant organs
STAGE 1A1 Treatment
conization.
* If the excision margins are clear (invasive and pre-invasive), no further treatment is
necessary.
* If the excision margins are involved, further local excision should be performed or a simple
hysterectomy
* If simple hysterectomy is chosen in the presence of incomplete margins, a
repeat cone should be performed to exclude more extensive
invasive disease that could necessitate a radical hysterectomy. MRI may be helpful.
* In case of LVSI- MRH+ pelvic lymphadenectomy is recommended.
STAGE 1A2 Treatment
Conisation/ RADICAL TRACHELECTOMY
* Modified Radical hysterectomy / simple hysterectomy in low risk.
* Pelvic lymphadenectomy is required.
* In those who are medically unfit, radical radiotherapy is an alternative treatment option
STAGE 1b1 treatment
radical hysterectomy and bilateral pelvic lymphadenectomy(
from common- iliac to femoral canal or radical radiotherapy, with equivalent cure rates.
* Radical trachelectomy – conservative fertility-sparing surgery in young patients with good
prognostic factors: tumours with largest diameter of
<2cm, without LVSI and without lymph node involvement. Radical trachelectomy and
lymphadenectomy – recurrence rate of < 5%.
Pregnancy – 41–78% is reported.
the medically fit, younger patient is treated with surgery and the unfit, older
patient treated with radiotherapy
Stage IB2–IVA treatment
- Chemo-radiation:- Radiotherapy is the primary mode of treatment, combined
with platinum-based chemotherapy
