Management of early-stage squamous cervical cancer

Early-stage cervical cancer refers to 2018 FIGO staging IA, IB1, and IB2 disease. Fertility-sparing surgery may be appropriate in certain patients (refer to related UpToDate topics).

For patients with early stage cervical cancer, final surgicopathologic results may impact management decisions. Other histologies (eg, adenocarcinoma, neuroendocrine tumors) are discussed in related UpToDate topics.

FIGO: International Federation of Gynecology and Obstetrics; LVSI: lymphovascular space invasion; MRI: magnetic resonance imaging.

* Simple hysterectomy may be an acceptable alternative.

¶ Lymphadenectomy is not required, but may be performed in some cases. Patients with inadequate or positive margins may require further surgery (refer to related UpToDate topics).

Δ Pathologic criteria used to define patients at intermediate or high risk include the following:

Presence of LVSI plus deep one-third cervical stromal invasion and tumor of any size
Presence of LVSI plus middle one-third stromal invasion and tumor size >2 cm
Presence of LVSI plus superficial one-third stromal invasion and tumor size >5 cm
Positive surgical margins
Pathologically confirmed involvement of the pelvic lymph nodes
Microscopic involvement of the parametrium

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Management of early-stage squamous cervical cancer