[Treatment of cervical cancer]

The treatment of uterine cervical cancer evolved the last past twenty years. The management of early stages cervical cancer is based on surgery +/- after an initial brachytherapy in order to increase loco-regional control. A conservative treatment preserving uterine and ovarian functions is sometimes possible for young patients < 40 years old wishing to conceive. This strategy allows pregnancies with low recurrence rate. Finally, the use of the sentinel lymph node staging should be validated within the next few years. The treatment of locally advanced stages is based on concomitant chemoradiation therapy, which allows obtaining an important complete tumour response rate (90%). Thereafter, the irradiation modalities will depend on the para-aortic lymph nodes status diagnosed by PET-computed tomography +/- staging laparoscopic para-aortic lymphadenectomy. The use of completion surgery may be indicated in case of cervical residual disease and has to be balanced with its specific morbidity. All the decisions are made during a multidisciplinary tumour board.