1 / 6

Management of FIGO Stage I Cervical Cancer: Which Surgical Approach Is Used at IEO ?

This article discusses the proposed algorithm for the management of early stage cervical cancer, focusing on the surgical approach used at the European Institute of Oncology in Milan, Italy. It also highlights the criteria for conservative surgery and the guidelines for adjuvant treatment.

jholt
Download Presentation

Management of FIGO Stage I Cervical Cancer: Which Surgical Approach Is Used at IEO ?

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Management of FIGO Stage I Cervical Cancer: Which Surgical Approach Is Used at IEO ? Nicoletta Colombo European Institute of Oncology Milan, Italy

  2. IEO PROPOSED ALGORITHM FOR EARLY STAGE CERVICAL CANCER Conservative Surgery FIGO STAGE IA1 – IB2* *FIGO IA1 LVSI neg no lymphadenectomyperformed ** In case of a conizationdoneelsewhere with adeguate specimen revised by ourpathologists, only MIS lymphadenectomyisperformed • Pregnancy Desire • Age < 40 • Squamous- Adeno- Adenosquamous carcinoma • Tumor Size >20 mm, <30 mm • Distance from internalos <10 mm • Tumor size <20 mm • Distance from internalos >10 mm • LNF Status assessment (MIS:SLN + PLND) • LNF Status assessment (MIS:SLN + PLND) • Laserconization ** If negative LNs: NACHT (experimentalonly) • Negative LNs with RiskFactors: • Free margin <3 mm • LVSI positive Negative LNs with no risk factors: • Positive LNs Large cone/ trachelectomy: Conservative treatment only with complete response or downstaged to IA1 Concomitant CHEMO-RADIATION/BRT • Follow Up • Pregnancyafter 12 months Adjuvant treatment

  3. IeoProposedAlgorithm For Early Stage CervicalCancer Definitive Surgery Invasive Cervical Cancer/Earlydisease FIGO IA2/IB1 FIGO IA1 FIGO IB2/IIA1 • No-LVSI: MIS: type A radical hysterectomy (QUERLEU-MORROW)* • With LVSI: MIS: type A radical hysterectomy + SLN + PLND (SENTICOL III)** • LPT: Type B radical hysterectomy + SNL + PLND * (SENTICOL III)** • Awaiting SERGS-ESGO-ESGE consensus after LACC study (possible MIS) • LPT: Type C1 radical hysterectomy + SNL + PLND * (SENTICOL III) )** • Awaiting SERGS-ESGO-ESGE consensus after LACC study (possible MIS only within RCT) Adjuvant treatment depending on riskfactors *BSO vs bilateral salpingectomy depending on age and risk factors **Whenapproved

  4. IeoProposedAlgorithm For Locally Advanced CervicalCancer Advanced Disease Invasive Cervical Cancer/Locallyadvanceddisease FIGO IVB FIGO IB3/IIA2 FIGO IIB/IVA ≤50 of age: neoadjuvant dose-dense chemotherapy (RM after 6 cycles): • CR or PR: complete 9 cyclesfollowed by LPT type C1 radical hysterectomy/BSO + PLND • SD or PD: Concomitant CHEMO-RADIATION/BRT • Concomitant CHEMO-RADIATION /BRT vs Enrollment in RCT (INTERLACE) >50 of age: • Concomitant CHEMO-RADIATION /BRT vs Enrollment in RCT (INTERLACE) • Chemotherapy (Cisplatinum-Paclitaxel-Bevacizumab) vs enrollment in RCT • DistantresponseConfirmed: CHEMO-RADIATION /BRT

  5. THANK YOU!

More Related