The Diagnosis, Treatment, and Aftercare of Cervical Carcinoma.
Beckmann M, Stübs F, Vordermark D, Koch MC, Horn LC, Fehm T (2021)
Publication Type: Journal article
Publication year: 2021
Journal
Book Volume: 118
Pages Range: 806-812
Journal Issue: 47
DOI: 10.3238/arztebl.m2021.0352
Abstract
BACKGROUND: Approximately 4380 cases of cervical carcinoma were diagnosed in Germany in 2016. In women who had not participated in early detection programs, cervical carcinoma was usually already in an advanced stage at the time of diagnosis. Certified structures for care in conformity with the existing guidelines are available. METHODS: The new German clinical practice guideline was revised with the participation of 50 medical societies under the expert guidance of the Guideline Program in Oncology, which includes the German Association of the Scientific Medical Societies (Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften, AWMF). A systematic literature review was conducted. Systematic reviews, meta-analyses, and randomized controlled trials (RCTs) were considered. RESULTS: The histologic tumor stage and lymph-node stage are essential determinants of the treatment strategy. The main innovation regarding surgical treatment is the revival of open hysterectomy (overall survival [minimally invasive vs open hysterectomy]: 94.04% vs 99.4%; hazard ratio [HR]: 6.00; 95% confidence interval [1.77; 20.30]). In addition, for tumors measuring 2 cm or less, sentinel node biopsy is recommended rather than radical pelvic lymphadenectomy. MRI-guided brachytherapy is an oblig atory component of radiochemotherapy (overall survival [radiochemotherapy with vs without brachytherapy]: 58.2% vs 46.2%, p<0.001). The standard palliative treatment consists of bevacizumab combined with a platinum-containing agent (overall survival: HR: 0.77 [0.62; 0.95]; p = 0.007). CONCLUSION: Despite the introduction of new treatments, the outcome of patients with advanced cervical carcinoma has not much improved. In the surgical treatment of cervical carcinoma, the open approach is now favored. The sentinel node biopsy technique has become well established for the surgical staging of small tumors. Controlled trials are needed so that the outcome of women with cervical carcinoma, particularly in its advanced and metastatic stages, can be improved.
Authors with CRIS profile
Matthias Beckmann
Lehrstuhl für Geburtshilfe und Frauenheilkunde
Frederik Stübs
Department of Obstetrics and Gynaecology
Involved external institutions
Universitätsklinikum Halle (Saale)
Germany (DE)
Universitätsklinikum Leipzig
Germany (DE)
Universitätsklinikum Düsseldorf
Germany (DE)
ANregiomed
Germany (DE)
Germany (DE)
Universitätsklinikum Leipzig
Germany (DE)
Universitätsklinikum Düsseldorf
Germany (DE)
ANregiomed
Germany (DE)
How to cite
APA:
Beckmann, M., Stübs, F., Vordermark, D., Koch, M.C., Horn, L.C., & Fehm, T. (2021). The Diagnosis, Treatment, and Aftercare of Cervical Carcinoma. Deutsches Ärzteblatt international, 118(47), 806-812. https://doi.org/10.3238/arztebl.m2021.0352
MLA:
Beckmann, Matthias, et al. "The Diagnosis, Treatment, and Aftercare of Cervical Carcinoma." Deutsches Ärzteblatt international 118.47 (2021): 806-812.
BibTeX: Download