Lukas Dostalek1, Elisabeth Åvall-Lundqvist2, Carien L Creutzberg3, Dina Kurdiani4, Jordi Ponce5, Iva Dostalkova6, David Cibula1. 1. Gynecologic Oncology Center, Department of Obstetrics and Gynecology, First Faculty of Medicine, Charles University, General University Hospital, Prague, Czech Republic. 2. Department of Oncology and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden. 3. Department of Radiation Oncology, Leiden University Medical Center, Leiden, the Netherlands. 4. Tbilisi Cancer Center, Tbilisi, Georgia. 5. Department of Gynaecology, University Hospital of Bellvitge, IDIBELL, University of Barcelona, Barcelona, Spain. 6. Faculty of Science, University of South Bohemia, Ceske Budejovice, Czech Republic.
Abstract
OBJECTIVE: The aim of this survey was to acquire an overview of the current management of cervical cancer with an emphasis on the early disease stages. MATERIALS AND METHODS: A hyperlink to the survey was sent to the European Society of Gynaecological Oncology Office database. The survey contained 6 groups of questions regarding the characteristics of respondents, pretreatment workup, management of the early stages of cervical cancer, adjuvant treatment, fertility-sparing treatment, and surveillance. RESULTS: In total, 566 responses were collected. The most frequent imaging method used in the workup was magnetic resonance imaging (74%), followed by computed tomography (54%) and positron emission tomography/computed tomography (25%). Conization or simple hysterectomy was a preferred procedure in stage T1a1 lymphovascular space invasion (LVSI)-positive for 79% of respondents, in stage T1a2 LVSI-negative for 58%, and in stage T1a2 LVSI-positive for 28%. Sentinel lymph node biopsy alone was reported in stage T1a1 by 17% and in stage T1b1 less than 2 cm by 9%, whereas systematic lymphadenectomy by 29% and 90% of respondents. Macrometastases, micrometastases, and isolated tumor cells in lymph nodes were considered indications for adjuvant treatment by 96%, 93%, and 68% of respondents, respectively. Neoadjuvant chemotherapy was reported by 28% and 19% of respondents in fertility-sparing and nonsparing management in stage T1b1. Over 60% of respondents recommend primary surgery for their patients with T1b2 N0 disease and 81% of them use a combination of adverse prognostic factors as indication for adjuvant radiotherapy in pN0 disease. CONCLUSIONS: The results of this survey indicate considerable differences in the workup and treatment of cervical cancer in current clinical practice.
OBJECTIVE: The aim of this survey was to acquire an overview of the current management of cervical cancer with an emphasis on the early disease stages. MATERIALS AND METHODS: A hyperlink to the survey was sent to the European Society of Gynaecological Oncology Office database. The survey contained 6 groups of questions regarding the characteristics of respondents, pretreatment workup, management of the early stages of cervical cancer, adjuvant treatment, fertility-sparing treatment, and surveillance. RESULTS: In total, 566 responses were collected. The most frequent imaging method used in the workup was magnetic resonance imaging (74%), followed by computed tomography (54%) and positron emission tomography/computed tomography (25%). Conization or simple hysterectomy was a preferred procedure in stage T1a1 lymphovascular space invasion (LVSI)-positive for 79% of respondents, in stage T1a2 LVSI-negative for 58%, and in stage T1a2 LVSI-positive for 28%. Sentinel lymph node biopsy alone was reported in stage T1a1 by 17% and in stage T1b1 less than 2 cm by 9%, whereas systematic lymphadenectomy by 29% and 90% of respondents. Macrometastases, micrometastases, and isolated tumor cells in lymph nodes were considered indications for adjuvant treatment by 96%, 93%, and 68% of respondents, respectively. Neoadjuvant chemotherapy was reported by 28% and 19% of respondents in fertility-sparing and nonsparing management in stage T1b1. Over 60% of respondents recommend primary surgery for their patients with T1b2 N0 disease and 81% of them use a combination of adverse prognostic factors as indication for adjuvant radiotherapy in pN0 disease. CONCLUSIONS: The results of this survey indicate considerable differences in the workup and treatment of cervical cancer in current clinical practice.
Authors: Violante Di Donato; Giuseppe Caruso; Marco Petrillo; Evangelos Kontopantelis; Innocenza Palaia; Giorgia Perniola; Francesco Plotti; Roberto Angioli; Ludovico Muzii; Pierluigi Benedetti Panici; Giorgio Bogani Journal: Vaccines (Basel) Date: 2021-04-21