Guideline for Gynecological MalignantTumors – Primary Complex Therapy in OperableStages of Malignant Tumors of Uterus Cervix

Overview

Objective:
Elaboration of guideline for primary treatment of operable cervical cancer.Design: Review, consensus between proposers and opponents.Setting: Department of Obstetrics and Gynecology, Charles University, Prague, 2nd Medical Facultyand Faculty Hospital Motol.Method: A retrospective review of published data, analysis of Czech statistics and consensusbetween proposers and opponents.Results: Team work is essential in the diagnostic and therapeutic procedure. For the preoperativediagnostic management it is possible to perform magnetic resonance volumometry. For thetreatment of early stage cervical cancer it is possible to perform sentinel lymph node mapping(SLNM) by patent blau and 99mTc together with frozen section. SLNM does not substitute systematicpelvic lymphadenectomy. For the treatment of IB2 stage cervical cancer, an alternative forprimary surgery or chemoradiotherapy is neoadjuvant chemotherapy, followed by radical surgery.In other topics only minor changes were made from the 1998 guideline.Conclusion: The guideline for cervical cancer treatment should represent directions for cliniciansand others, who participate in the process of the treatment of cervical cancer. The guidelinesinclude all parts of the process (from diagnosis to follow up). It originated from the consensusbetween proposers and opponents: we voted about all parts of guideline.

Key words:
cervical cancer, guideline, diagnosis, treatment, follow up