Cervical cancer Flashcards
Cervical cancer RF’s
- HPV
- HIV
- smoking
- immunosuppression
Presentation of late stage disease
- pelvic/back pain
- leg swelling
- weight loss
*Fistulas (rectovaginal and vesicovaginal)
management of abnormal pap with no visible lesion
cervical conization/LEEP (ensure clear margin)
Management of cervical cancer <2 cm with < 10 mm of stromal invasion
simple hysterectomy
What is locally advanced for cervical?
Node positive OR greater than 4 cm
Management of locally advanced cervical
Primary chemoradiation (w/ cisplatin) + brachytherapy
Management of stage IA1 if wanting to preserve fertility
Cervical conization
Management of Stage IA2-IB2
Radical hysterectomy with lymphadenectomy
Management of stage IA2-IB2 in patient wanting to preserve fertility
- radical trachelectomy with lymphadenectomy
Management of early stage IA2-IB2 in nonsurgical candidate
Radiation
Indications for adjuvant CRT in cervical
- positive margins
- positive lymph nodes
*parametrial involvement
Management of locally recurrent cervical
IF prior radiation (most), surgery (pelvic extenteration)
IF prior surgery, radiation
Major SE with bev for cervical cancer
fistula formation
First line for metastatic cervical cancer
IF PD-L1 positive (CPS>1) (most patients), platinum + paclitaxel + pembro +/- avastin for up to 6 cycles
IF PD-L1 negative, platinum/taxol/bev
Preferred second line in metastatic cervical cancer
Tisotumab vedotin
