OGCO-E3.3 CA cervix

Question 1

What is the initial workup for cervical cancer?

Answer 1

History and physical examination
Complete blood count
Liver and renal function tests
SCC / CA125
Chest X-ray
Renal tract imaging (Ultrasound or IVU or CT/MRI)
Slide review for biopsy taken in other institutions +/- PDL1 status

Optional Ix
EUA
Cystoscopy
Sigmoidoscopy
MRI or CT scan or PET-CT

Question 2

For cervical cancer what are the indications for post operative adjuvant chemoradiation?

Answer 2

Positive pelvic lymph nodes
Positive or close resection margins (< 5 mm)

Question 3

For cervical cancer what are the indications for post operative adjuvant radiatherapy?

Answer 3

(1) Positive CLS (capillary-like space), Deep 1/3 stromal invasion
(2) Positive CLS, Middle 1/3 stromal invasion, Tumour size ≥ 2 cm
(3) Positive CLS, Superficial 1/3 stromal invasion, Tumour size ≥ 5 cm
(4) Negative CLS, Deep or Middle 1/3 stromal invasion, Tumour size ≥ 4 cm

Question 4

For cervical cancer what are the indications for post op adjuvant chemoradiation after radical hysterectomy?

Answer 4

Standard field pelvic irradiation
Cisplatin 40mg/m2 weekly during ERT

Question 5

What is concurrent chemoradiation done for CA cervix?

Answer 5

Question 6

What is possible chemotherapy for ca cervix recurrence?

Answer 6

Question 7

Suggested Patient Selection Criteria for Radical Trachelectomy in Patients with Proven Cervical Cancer Desiring Future Fertility

Answer 7

1. Stage IA2 or Stage IB1 disease
2. Tumour size ≤ 2 cm
3. Favourable histology (including squamous cell carcinoma, adenocarcinoma or adenosquamous carcinoma)
4. No evidence of lymph node, or distal metastases or extensive LVSI
5. Estimated length of cervix >1 cm (on imaging)

Question 8

Post-treatment Follow-up for Cervical Cancer

Answer 8

Question 9

Overview of treatment for cervical cancer

Answer 9

Question 10

Treatment algorithm for cervical cancer?

Answer 10