This protocol covers first-line management of cervical cancer confirmed at FIGO stage IA2, stage IB, or stage IIA — a staging range in which definitive surgical intervention is the primary treatment pathway, with the specific procedure guided by individual patient factors including fertility intentions.
The patient has cervical cancer staged as FIGO IA2, IB, or IIA. This encompasses tumours from microscopic invasion beyond the earliest stage through to involvement of the upper vagina, representing a population for whom surgical management is considered standard of care.
Patient preference regarding future fertility is a key factor in determining which surgical approach is appropriate.
Management is surgical, involving intervention at the level of the cervix together with assessment and removal of regional lymph nodes. Two broad paths exist depending on whether fertility preservation is desired — the standard approach differs substantially from the fertility-sparing alternative. Surgical access options are also part of the decision.
The complete procedure selection criteria, technical options, and full regimen are detailed in the structured protocol.
DOI: 10.1093/annonc/mdx220
In patients with FIGO stage IA2, IB and IIA, radical hysterectomy with bilateral lymph node dissection (with or without SLN) is standard treatment, if the patient does not wish to preserve fertility [I, B].
This can be carried out either by laparotomy or laparoscopy (which can be robotically assisted).
For patients wishing to preserve fertility, cone biopsy or radical trachelectomy with PLND is the standard procedure.
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