SEOM clinical guidelines for cervical cancer (2019)

Area of Science:

• Oncology
• Gynecologic Oncology
• Public Health

Background:

• Cervical cancer (CC) is the fourth most common cancer globally in women, primarily caused by high-risk human papillomavirus (HPV) infection.
• Screening programs have reduced CC incidence in high-income countries, but accessibility remains a challenge in developing regions, contributing to significant mortality.
• Clinical stage is the most critical prognostic factor in cervical cancer management.

Purpose of the Study:

• To review the current understanding of cervical cancer epidemiology, staging, and treatment modalities.
• To highlight advancements in the FIGO staging system and their impact on prognosis.
• To discuss evolving therapeutic strategies for early-stage, advanced, recurrent, and metastatic cervical cancer.

Main Methods:

• Review of current literature on cervical cancer epidemiology, staging, and treatment.
• Analysis of the updated FIGO staging system (2018) incorporating lymph node status.
• Summary of established and emerging treatment options, including surgery, radiotherapy, chemotherapy, and immunotherapy.

Main Results:

• The 2018 FIGO staging system provides more accurate prognostication by including lymph node status.
• Treatment strategies vary by stage: surgery or radiotherapy for early stages, chemoradiotherapy for locally advanced disease.
• Chemotherapy combined with bevacizumab is preferred for recurrent or metastatic CC; immunotherapy is emerging post-platinum therapy failure.

Conclusions:

• Accurate staging, particularly with the updated FIGO system, is crucial for effective cervical cancer management.
• A multimodal treatment approach, tailored to disease stage, is essential for improving patient outcomes.
• Emerging therapies like immunotherapy represent promising future directions for cervical cancer treatment.