Management of early-stage and locally advanced cervical cancer

Abstract

Carcinoma of the cervix remains a significant health problem for women worldwide. However, the use of a multidisciplinary approach to the treatment of cervical cancer has led to a marked improvement in patient outcomes. It has been demonstrated that early-stage cervical cancer can be effectively treated with radical surgery or definitive radiotherapy, which achieve similar survival outcomes. To reduce the frequency of postoperative complications, less invasive surgical procedures involving laparoscopic or robotic approaches have been introduced. Moreover, for patients who wish to preserve their fertility, fertility-preserving surgery has been developed. Concurrent chemoradiotherapy with a platinum-based agent is the recommended treatment for locally advanced cervical cancer. The standard concurrent chemotherapy regimen involves the administration of single-agent cisplatin at a weekly dose of 40 mg/m2 during external beam radiotherapy. Overall, when added to radiotherapy, cisplatin was demonstrated to reduce the risk of death from cervical cancer; i.e., it resulted in an absolute overall survival benefit of 10%. In this chapter, we summarize the current management strategies for early and locally advanced cervical carcinoma.