Management of early-stage cervical cancer

Early-stage cervical cancer refers to FIGO stage 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.

LVSI: lymphovascular space invasion; FIGO: International Federation of Gynecology and Obstetrics.

* 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 Intermediate- or high-risk features on final surgical pathology may impact management decisions; such findings 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 cervical cancer