Treatment of Invasive Cervical Cancer Diagnosed on Simple Hysterectomy Specimen
When invasive cervical cancer is discovered incidentally on a simple hysterectomy specimen, the clinical situation requires careful reassessment. The extent of residual disease — particularly at the parametria — drives the next steps in management.
Clinical Scenario
In pathologically node-negative patients with T1b1 disease, potential disease in the parametria must be addressed. The absence of lymph node involvement shapes the choice between surgical and radiation-based approaches.
Treatment Approach (Overview)
Management centres on addressing the parametria and upper vagina, with surgical options or radiotherapy considered based on availability and individual risk-benefit. Specific eligibility criteria — including tumour characteristics — determine whether certain procedures can be safely avoided.
Full regimen detail, sequencing, and eligibility criteria available in the complete protocol.
References
DOI: 10.1016/j.ijgc.2025.102747
- In pathologically node-negative patients with T1b1 disease, potential disease in the parametria should be addressed. Parametrectomy and upper vaginectomy should be considered.
- Radical surgery should be considered, aiming at decreasing the risk of local recurrence, composed of parametrectomy, upper vaginectomy, and systematic pelvic lymphadenectomy.
- Pelvic radiotherapy should be considered.
- Radiotherapy can be considered as an alternative modality to surgical treatment, considering the risk-benefit of repeat surgery.
- Avoidance of parametrectomy and upper vaginectomy can be considered in tumors meeting the SHAPE trial criteria.
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