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The European Society of Gynaecological Oncology/European Society for Radiotherapy and Oncology/European Society of Pathology Guidelines for the Management of Patients With Cervical Cancer
  1. David Cibula, MD*,
  2. Richard Pötter, MD,
  3. François Planchamp, MSc,
  4. Elisabeth Avall-Lundqvist, MD§,
  5. Daniela Fischerova, MD*,
  6. Christine Haie Meder, MD,
  7. Christhardt Köhler, MD,
  8. Fabio Landoni, MD#,
  9. Sigurd Lax, MD**,
  10. Jacob Christian Lindegaard, MD,,
  11. Umesh Mahantshetty, MD,,
  12. Patrice Mathevet, MD§§,
  13. W. Glenn McCluggage, MD∥∥,
  14. Mary McCormack, MD¶¶,
  15. Raj Naik, MD##,
  16. Remi Nout, MD***,
  17. Sandro Pignata, MD†††,
  18. Jordi Ponce, MD‡‡‡,
  19. Denis Querleu, MD,
  20. Francesco Raspagliesi, MD§,§§,
  21. Alexandros Rodolakis, MD∥∥,
  22. Karl Tamussino, MD¶¶¶,
  23. Pauline Wimberger, MD#,## and
  24. Maria Rosaria Raspollini, MD****
  1. * Gynecologic Oncology Center, Department of Obstetrics and Gynecology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic;
  2. Department of Radiotherapy, Medical University of Vienna, Vienna, Austria;
  3. Institut Bergonié, Bordeaux, France;
  4. § Linkoping University, Linkoping, Sweden;
  5. Department of Radiotherapy, Institut Gustave Roussy, Villejuif, France;
  6. Asklepios Hambourg Altona and University of Cologne, Medical Faculty, Department of Gynecology, Germany;
  7. # University of Milan Bicocca, Monza, Italy;
  8. ** General Hospital Graz Sued-West, Graz, Austria;
  9. †† Department of Oncology, Aarhus University, Aarhus, Denmark;
  10. ‡‡ Department of Radiation Oncology, Tata Memorial Hospital, Mumbai, India;
  11. §§ Lausanne University, Lausanne, Switzerland;
  12. ∥∥ Department of Pathology, Belfast Health and Social Care Trust, Belfast, United Kingdom;
  13. ¶¶ University College Hospital London, London, United Kingdom;
  14. ## Queen Elizabeth Hospital, Gateshead, United Kingdom;
  15. *** Department of Radiation Oncology, Leiden University, Leiden, the Netherlands;
  16. ††† Istituto Nazionale per lo Studio e la Cura dei Tumori “FondazioneG Pascale,” IRCCS, Naples, Italy;
  17. ‡‡‡ University Hospital of Bellvitge (IDIBELL), Barcelona, Spain; §§§Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy; ∥∥∥Athens University, Athens, Greece;
  18. ¶¶¶ Medical University of Graz, Graz, Austria; ###Dresden University, TU Dresden, Dresden, Germany;
  19. **** University Hospital, Careggi, Florence, Italy.
  1. Address correspondence and reprint requests to David Cibula, MD, Department of Obstetrics and Gynecology, Kateřinská 32, 121 08 Prague, Czech Republic. E-mail: dc{at}


Background Despite significant advances in the screening, detection, and treatment of preinvasive cervical lesions, invasive cervical cancer is the fifth most common cancer in European women. There are large disparities in Europe and worldwide in the incidence, management, and mortality of cervical cancer.

Objective The European Society of Gynaecological Oncology (ESGO), the European Society for Radiotherapy and Oncology (ESTRO), and the European Society of Pathology (ESP) jointly develop clinically relevant and evidence-based guidelines in order to improve the quality of care for women with cervical cancer across Europe and worldwide.

Methods The ESGO/ESTRO/ESP nominated an international multidisciplinary development group consisting of practicing clinicians and researchers who have demonstrated leadership and expertise in the care and research of cervical cancer (23 experts across Europe). To ensure that the guidelines are evidence based, the current literature identified from a systematic search was reviewed and critically appraised. In the absence of any clear scientific evidence, judgment was based on the professional experience and consensus of the development group. The guidelines are thus based on the best available evidence and expert agreement. Prior to publication, the guidelines were reviewed by 159 international reviewers, selected through ESGO/ESTRO/ESP and including patient representatives.

Results The guidelines cover comprehensively staging, management, and follow-up for patients with cervical cancer. Management includes fertility sparing treatment; stage T1a, T1b1/T2a1, clinically occult cervical cancer diagnosed after simple hysterectomy; early and locally advanced cervical cancer; primary distant metastatic disease; cervical cancer in pregnancy; and recurrent disease. Principles of radiotherapy and pathological evaluation are defined.

  • Cervical cancer
  • Guidelines
  • Management
  • Staging
  • Follow-up

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  • The authors declare no conflicts of interest.