The Polish Society of Gynecological Oncology Guidelines for the Diagnosis and Treatment of Cervical Cancer (v2024.0)-Reference-Cited by-同舟云学术

The Polish Society of Gynecological Oncology Guidelines for the Diagnosis and Treatment of Cervical Cancer (v2024.0)

Published:2024-07-25 Issue:15 Volume:13 Page:4351
ISSN:2077-0383
Container-title:Journal of Clinical Medicine
language:en
Short-container-title:JCM

Author:

Sznurkowski Jacek J.¹^ORCID,Bodnar Lubomir²³,Szylberg Łukasz⁴⁵^ORCID,Zołciak-Siwinska Agnieszka⁶,Dańska-Bidzińska Anna⁷,Klasa-Mazurkiewicz Dagmara⁸^ORCID,Rychlik Agnieszka⁶,Kowalik Artur⁹¹⁰^ORCID,Streb Joanna¹¹,Bidziński Mariusz⁶^ORCID,Sawicki Włodzimierz¹²

Affiliation:

1. Profesor Sznurkowski Podmiot Leczniczy, ul. Stefana Żeromskiego 23A, 81-246 Gdynia, Poland

2. Faculty of Medical Sciences and Health Sciences, University of Siedlce, 08-110 Siedlce, Poland

3. Department of Clinical Oncology and Radiotherapy, Siedlce Cancer Center, 08-110 Siedlce, Poland

4. Department of Tumor Pathology and Pathomorphology, Oncology Centre Prof. Franciszek Łukaszczyk Memorial Hospital, 85-796 Bydgoszcz, Poland

5. Department of Obstetrics, Gynecology and Oncology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, 85-168 Bydgoszcz, Poland

6. Department of Gynecological Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland

7. Department of Gynecologic Oncology, Second Clinic of Obstetrics and Gynecology, Medical University of Warsaw, 02-091 Warsaw, Poland

8. Department of Obstetrics and Gynecological Oncology, Medical University of Gdańsk, 80-210 Gdańsk, Poland

9. Department of Molecular Diagnostics, Holy Cross Cancer Center, 25-734 Kielce, Poland

10. Division of Medical Biology, Institute of Biology, Jan Kochanowski University, 25-406 Kielce, Poland

11. Department of Oncology, Jagiellonian University Medical College, 31-008 Krakow, Poland

12. Department of Obstetrics and Gynecological Oncology, Medical University of Warsaw, 02-091 Warsaw, Poland

Abstract

Background: Recent publications underscore the need for updated recommendations addressing less radical surgery for <2 cm tumors, induction chemotherapy, or immunotherapy for locally advanced stages of cervical cancer, as well as for the systemic therapy for recurrent or metastatic cervical cancer. Aim: To summarize the current evidence for the diagnosis, treatment, and follow-up of cervical cancer and provide evidence-based clinical practice recommendations. Methods: Developed according to AGREE II standards, the guidelines classify scientific evidence based on the Agency for Health Technology Assessment and Tariff System criteria. Recommendations are graded by evidence strength and consensus level from the development group. Key Results: (1) Early-Stage Cancer: Stromal invasion and lymphovascular space involvement (LVSI) from pretreatment biopsy identify candidates for surgery, particularly for simple hysterectomy. (2) Surgical Approach: Minimally invasive surgery is not recommended, except for T1A, LVSI-negative tumors, due to a reduction in life expectancy. (3) Locally Advanced Cancer: concurrent chemoradiation (CCRT) followed by brachytherapy (BRT) is the cornerstone treatment. Low-risk patients (fewer than two metastatic nodes or FIGO IB2-II) may consider induction chemotherapy (ICT) followed by CCRT and BRT after 7 days. High-risk patients (two or more metastatic nodes or FIGO IIIA, IIIB, and IVA) benefit from pembrolizumab with CCRT and maintenance therapy. (4) Metastatic, Persistent, and Recurrent Cancer: A PD-L1 status from pretreatment biopsy identifies candidates for Pembrolizumab with available systemic treatment, while triplet therapy (Atezolizumab/Bevacizumab/chemotherapy) becomes a PD-L1-independent option. Conclusions: These evidence-based guidelines aim to improve clinical outcomes through precise treatment strategies based on individual risk factors, predictors, and disease stages.

Publisher

MDPI AG

Link

https://www.mdpi.com/2077-0383/13/15/4351/pdf

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