Stage IIB-IVA cancer of the cervix.
Stage IIB-IVA cancer of the cervix represents locally advanced-stage disease that has extended beyond the cervix without clinical evidence of extrapelvic metastasis. Localized surgery is seldom used as the extent of the disease precludes and an adequate surgical margin. Both sophisticated imaging and surgical staging have been utilized to accurately assess the extent of disease for treatment planning. Careful attention to radiation technique and the use of brachytherapy impact survival and treatment morbidity. Concurrent cisplatin-based chemotherapy has become the accepted standard based on randomized clinical trials (level 1 evidence). Further improvements may be achieved with combination chemotherapy, hyperthermia or prophylactic extended field radiation. However, these improvements, currently practiced in developed countries, must be implemented in underdeveloped countries which have the greatest burden of this disease.
Rose
Peter G
PG
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio 44109, USA. prose@metrohealth.org
D003657:Decision Making; D005260:Female; D006801:Humans; D009367:Neoplasm Staging; D016032:Randomized Controlled Trials as Topic; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000628:therapy*