Current treatment of cervical cancer: progress and prospects

Pérez Villena J.F. · Revista Peruana de Ginecologia y Obstetricia (2024) · DOI: 10.31403/rpgo.v70i2695

Resumen

Standard treatment for early cervical cancer is mainly by laparotomy. Lymph node assessment is essential, utilizing sentinel lymph nodes and pelvic lymphadenectomy. If intraoperative lymph node involvement is identified, it is preferable to avoid dissection and opt for chemoradiotherapy. Radical type C hysterectomy is the usual approach, although extrafascial hysterectomy may be considered in low-risk patients. The SHAPE study suggests that there are no significant differences in recurrence-free survival between the two types of hysterectomy. In young women who wish to preserve their fertility, conization or radical trachelectomy are viable options in stages IA2-IB1. In stages IB3 and IIA2, concurrent chemoradiotherapy is preferred and has shown more favorable survival results. Neoadjuvant chemotherapy is applied in settings where radiotherapy is not available. For patients with early disease, radiotherapy may be an alternative if there are contraindications to surgery. Finally, adjuvant radiotherapy is recommended for patients with high-risk factors after surgery, while low-risk patients do not require additional treatment, thus allowing for a personalized approach based on individual patient characteristics.