Introduction/Background*Cervical cancer represents the fourth most common malignancy in women, with more than half a million new cases each year worldwide. Despite HPV-based screening programs, liquid-based cytology and national vaccination programs, a significant number of patients present with advanced stage disease, beyond the ability to be provided with surgical treatment.
Methodology We conducted a retrospective analysis of new cervical cancer cases presented in our multidisciplinary tumor board from 2005 to 2018. Patients were offered pelvic examination and biopsy, with or without colposcopy. In certain cases, examination under anesthesia was mandatory, in order to assess parametrial involvement. Magnetic resonance imaging of the pelvis and computed tomography of the upper abdomen are part of the obligatory initial investigation for assessment of a pelvic tumor and distant spread of the disease. Cervical cancer stages for each patient were modified according to 2018 International Federation of Gynecology and Obstetrics (FIGO) staging for cervical cancer.
Result(s)*A total of 1896 new cervical cancer cases were assessed by our multidisciplinary tumor board in a period of 14 years. Five hundred and eight patients (27%) were eligible for surgical treatment. Distribution according to stage revealed 62 patients with stage IA2 (12%), 318 (63%) IB1, 82(16%) IB2 and 46 patients (9%) with stage IIA. Class B radical hysterectomy was performed in 380 patients (75%), while the rest 128 (25%) underwent a Class C procedure. In all cases, we performed a full bilateral pelvic lymphadenectomy, followed by palpation of para-aortic lymph nodes. We also recorded 90 (4.7%) patients eligible for fertility-sparing treatment, that underwent radical trachelectomy with pelvic lymphadenectomy. The rest 1388 patients were diagnosed with advanced stage disease (IIB-IV) and were referred to definitive concurrent chemoradiation treatment or chemotherapy, followed by radical radiotherapy and brachytherapy.
Conclusion*Designing the optimal treatment for patients diagnosed with cervical cancer demands a multidisciplinary approach, a thorough assessment of the extension of the disease and a detailed consultation for the patient and her family.
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