Management for Cervical Cancer Patients: A Comparison of the Guidelines from the International Scientific Societies (ESGO-NCCN-ASCO-AIOM-FIGO-BGCS-SEOM-ESMO-JSGO)

Author:

Restaino Stefano12ORCID,Pellecchia Giulia13ORCID,Arcieri Martina1ORCID,Bogani Giorgio4ORCID,Taliento Cristina56ORCID,Greco Pantaleo5ORCID,Driul Lorenza13,Chiantera Vito78,Ercoli Alfredo9,Fanfani Francesco10,Fagotti Anna10,Ciavattini Andrea11ORCID,Scambia Giovanni10,Vizzielli Giuseppe13ORCID,

Affiliation:

1. Clinic of Obstetrics and Gynecology, “Santa Maria della Misericordia” University Hospital, Azienda Sanitaria Universitaria Friuli Centrale, 33100 Udine, Italy

2. PhD School in Biomedical Sciences, Gender Medicine, Child and Women Health, University of Sassari, 07100 Sassari, Italy

3. Department of Medicine, University of Udine, 33100 Udine, Italy

4. Gynaecological Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, 20133 Milano, Italy

5. Department of Medical Sciences, Obstetrics and Gynecology Unit, University of Ferrara, 44121 Ferrara, Italy

6. Department of Development and Regeneration, Woman and Child, KU Leuven, 3000 Leuven, Belgium

7. Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90133 Palermo, Italy

8. Unit of Gynecologic Oncology, National Cancer Institute, IRCCS, Fondazione “G. Pascale”, 80131 Naples, Italy

9. Department of Human Pathology in Adult and Childhood “G. Barresi”, University of Messina, 98122 Messina, Italy

10. Gynecologic Oncology Unit, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy

11. Woman’s Health Sciences Department, Gynecologic Section, Polytechnic University of Marche, 60121 Ancona, Italy

Abstract

Cervical cancer continues to have a significant incidence, despite global efforts in HPV vaccination campaigns. Managing this condition involves a diverse team of healthcare professionals. Research in this field is undergoing a period of great revolution in multiple areas, and international guidelines will soon have to adapt to new scientific evidence. This could be true mainly in locally advanced stages, and it could also be true for minimal invasive surgery. This paper aims to summarize and compare the most recent recommendations published by international gynecological oncological societies for patients with cervical cancer. From their comparison, common aspects and disagreements emerged, especially in the diagnostic pathway and follow-up strategies. Several issues that remain to be debated in the literature were addressed and compared, highlighting similarities and differences, from the role of the sentinel lymph node in early stages to that of the adjuvant hysterectomy in locally advanced tumors. On the surgical side, for this last subset of patients, currently, a laparotomic approach is recommended. At the same time, the advent of immunotherapy has just opened up new and promising scenarios in systemic treatment for locally advanced cervical cancer, and international guidelines will soon introduce it into their algorithms.

Publisher

MDPI AG

Reference80 articles.

1. (2024, March 08). SEER Cancer Stat Facts: Cervix Uteri Cancer, Available online: https://seer.cancer.gov/statfacts/html/cervix.html.

2. Erratum: Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries;Bray;CA Cancer, J. Clin.,2020

3. International Federation of Gynecology and Obstetrics Global Declaration on Cervical Cancer Elimination;Congress;Rev. Bras. Hematol. Hemoter.,2019

4. Minimally Invasive versus Abdominal Radical Hysterectomy for Cervical Cancer;Ramirez;N. Engl. J. Med.,2018

5. Radiosensitizers in cervical cancer. Cisplatin and beyond;Candelaria;Radiat. Oncol.,2006

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