Cervical cancer Flashcards
Which HPV strains are associated with cervical cancer?
16 & 18 are associated in 70-80% of cervical cancers (to a lesser extensive 33 and 58)
What is SOC for locally advanced cervical cancer?
Chemoradiotherapy. EBRT with cisplatin followed by intracavity brachytherapy.
When should PET-CT be perfomed in cervical cancer?
3m post treatment, consider surgery if persistent/residual disease
What is recommended for patients who have not yet completed their families who will have chemoRT?
Ovarian stimulation with embryo storage and surrogate pregnancy.
What is SOC for early cervical cancer
Radical hysterectomy, BLSO and bilateral pelvic lymphadenectomy is suggested for FIGO IA2, IB1 and IB2.
Which FIGO stage is considered locally advanced?
IB3 (tumour >4cm) or above
When should adjuvant chemoradiotherapy be offered following surgery?
In presence of high risk features: LN involvement, parametrial spread, positive margins or those with two intermediate risk features: LVSI, tumour >4cm and deep cervical stromal invasion (>1/3)
How would you manage local recurrence of cervical cancer?
If had surgery then chemoRT, if had chemoRT then surgery
First line management of metastatic cervical cancer/
Pembrolizumab + carboplatin + paclitaxel +- bevacizumab in suitable patients
Second line options in metastatic cervical cancer?
Rechallenge with platinum based chemo if >6m DFI. Otherwise no 2nd line SOB, consider clinic trials.
How would cervical cancer during pregnancy be managed?
NACT with carboplatin and paclitaxel until foetal maturity, deliver via LSCS to avoid seeding into episiotomy scar.
Management of IB1 disease?
Radical trachelectomy with pelvic lymphadenectomy
Fertility preserving surgery is validated for use in what size of tumour?
<2cm
What HPV strains are vaccinated against in the Gardasil vaccine?
HPV 16 +18, HPV 6 + 11
What HPV strains are vaccinated against in the Gardasil vaccine?
HPV 16 +18, HPV 6 + 11
