علاج سرطان عنق الرحم في المرحلة T1b1 أو T1b2 أو T2a1

References

DOI: 10.1016/j.ijgc.2025.102747

• Lymph node assessment should be performed as the first step of surgical management.
• Intra-operative assessment of lymph node status (evaluated by frozen section) is recommended.
• Simple hysterectomy should be performed in patients who meet "SHAPE trial criteria" after conization or on preoperative staging, including tumor size ≤ 2 cm and a limited stromal invasion.
• In tumors exceeding the SHAPE criteria, the type of radical hysterectomy (extent of parametrial resection, type A-C2) should be based on the presence of prognostic risk factors identified preoperatively, such as tumor size, maximum stromal invasion, and lymphovascular space involvement, which are used to categorize patients at high, intermediate, and low risk of treatment failure.
• If a combination of risk factors is known at diagnosis, which would require an adjuvant treatment, definitive chemoradiotherapy and brachytherapy should be considered without previous radical pelvic surgery.