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[Evaluation and treatment of cervical cancer]
P Morice1, C Haie-Meder, C Lhommé
1Services de chirurgie de curiethérapie et de gynécologie médicale Institut Gustave-Roussy 39, rue Camille-Desmoulins 94805 Villejuif.
Abstract:
Tumour stage, tumour size and nodal status are the most important prognostic factors in cervical cancer. Treatment of invasive cervical carcinoma consists of radio-surgical combination, exclusive radiation therapy or exclusive surgery in favourable cases. Radical hysterectomy with lymphadenectomy (pelvic +/- para-aortic) is the reference technical surgery in stage IB and II cervical carcinoma. Conservative surgery can be discussed in young patients with stage IB1 disease. Radiotherapeutic treatment is based on a combination of external irradiation and brachytherapy, with concomitant chemotherapy when bad prognostic factors are present. This treatment represents the reference treatment in advanced stages. Total dose, overall treatment time are important prognostic factors of survival and local control. Pelvic exenteration with reconstructive surgery could be discussed in young patients with centro-pelvic recurrence of a cervical carcinoma.