Management of metastatic and recurrent cervical cancer

Abstract

Treatment guidelines for uterine cervical cancer have been established based on the findings of randomized clinical trials conducted in the past few decades. Although most cases of cervical cancer can be adequately managed with standard treatments, problems can arise in cases involving unusual presentations. Metastatic and recurrent cervical cancers are considered to be incurable. Although attempts have been made to treat patients with metastatic or recurrent cervical cancer with a variety of approaches including chemotherapy, radiotherapy, and surgery (as monotherapies or in combination), such patients have a dismal prognosis, with a reported 5-year survival rate of <10%. In this chapter, we first review the current management strategies for metastatic or recurrent cervical cancer. Then, we review the management strategies for unusual cases of cervical cancer, such as those involving the incidental detection of cervical cancer during pregnancy or in hysterectomy specimens, bulky lymph nodes, cervical stump cancer, cervical bleeding or ureteral obstruction, or unusual cervical cancer cell types.