Cervical_Cancer_Management Flashcards
How is the management of cervical cancer determined?
The management of cervical cancer is determined by the FIGO staging and the wishes of the patient to maintain fertility.
What is FIGO staging?
FIGO staging is a system used to describe the extent of cervical cancer based on the size of the tumor and the extent of spread.
Describe FIGO Stage IA for cervical cancer.
Stage IA is confined to the cervix, only visible by microscopy and less than 7 mm wide: A1 = < 3 mm deep, A2 = 3-5 mm deep.
Describe FIGO Stage IB for cervical cancer.
Stage IB is confined to the cervix, clinically visible or larger than 7 mm wide: B1 = < 4 cm diameter, B2 = > 4 cm diameter.
Describe FIGO Stage II for cervical cancer.
Stage II involves extension of the tumor beyond the cervix but not to the pelvic wall: A = upper two thirds of vagina, B = parametrial involvement.
Describe FIGO Stage III for cervical cancer.
Stage III involves extension of the tumor beyond the cervix and to the pelvic wall: A = lower third of vagina, B = pelvic side wall.
Describe FIGO Stage IV for cervical cancer.
Stage IV involves extension of the tumor beyond the pelvis or involvement of the bladder or rectum: A = involvement of bladder or rectum, B = involvement of distant sites outside the pelvis.
What is the gold standard treatment for stage IA cervical cancer?
The gold standard treatment for stage IA cervical cancer is hysterectomy +/- lymph node clearance.
What is the management option for stage IA patients wanting to maintain fertility?
For stage IA patients wanting to maintain fertility, a cone biopsy with negative margins or a radical trachelectomy can be performed, with close follow-up advised.
What is the recommended management for stage IB1 cervical cancer?
The recommended management for stage IB1 cervical cancer is radiotherapy with concurrent chemotherapy (commonly using cisplatin).
What is the recommended management for stage IB2 cervical cancer?
The recommended management for stage IB2 cervical cancer is radical hysterectomy with pelvic lymph node dissection.
How are stage II and III cervical cancer tumors typically managed?
Stage II and III cervical cancer tumors are typically managed with radiation and concurrent chemotherapy.
What should be considered if there is hydronephrosis in stage II or III cervical cancer?
If there is hydronephrosis in stage II or III cervical cancer, nephrostomy should be considered.
What is the treatment of choice for stage IV cervical cancer?
The treatment of choice for stage IV cervical cancer is radiation and/or chemotherapy, with palliative chemotherapy being an option for stage IVB.
What is the management for recurrent cervical cancer if primary treatment was surgical?
If primary treatment for recurrent cervical cancer was surgical, offer chemoradiation or radiotherapy.
What is the management for recurrent cervical cancer if primary treatment was radiation?
If primary treatment for recurrent cervical cancer was radiation, offer surgical therapy.
How does FIGO staging affect the prognosis of cervical cancer?
The prognosis of cervical cancer depends on the FIGO staging, with survival rates decreasing as the stage increases.
What are the 1-year and 5-year survival rates for FIGO Stage I cervical cancer?
The 1-year and 5-year survival rates for FIGO Stage I cervical cancer are 99% and 96%, respectively.
What are the 1-year and 5-year survival rates for FIGO Stage II cervical cancer?
The 1-year and 5-year survival rates for FIGO Stage II cervical cancer are 85% and 54%, respectively.
What are the 1-year and 5-year survival rates for FIGO Stage III cervical cancer?
The 1-year and 5-year survival rates for FIGO Stage III cervical cancer are 74% and 38%, respectively.
What are the 1-year and 5-year survival rates for FIGO Stage IV cervical cancer?
The 1-year and 5-year survival rates for FIGO Stage IV cervical cancer are 35% and 5%, respectively.
What are the standard complications of surgery for cervical cancer?
Standard complications of surgery for cervical cancer include bleeding, damage to local structures, infection, and anaesthetic risk.
What are the complications of cone biopsies and radical trachelectomy?
Complications of cone biopsies and radical trachelectomy include an increased risk of preterm birth in future pregnancies.
What is a possible complication of radical hysterectomy?
A possible complication of radical hysterectomy is a ureteral fistula.
What are the short-term complications of radiotherapy for cervical cancer?
Short-term complications of radiotherapy for cervical cancer include diarrhoea, vaginal bleeding, radiation burns, pain on micturition, and tiredness/weakness.
What are the long-term complications of radiotherapy for cervical cancer?
Long-term complications of radiotherapy for cervical cancer include ovarian failure, fibrosis of the bowel/skin/bladder/vagina, and lymphoedema.
