What are the guidelines for treating early-stage (IA1) cervical cancer?

Updated: Feb 12, 2019
  • Author: Cecelia H Boardman, MD; Chief Editor: Warner K Huh, MD  more...
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ESMO and NCCN guidelines are in agreement that the treatment of choice for stage IA1 disease with no lymphovascular space invasion (LVSI) is fertility-sparing cone biopsy, or if preservation of fertility is not relevant, simple hysterectomy. For stage IA1 with LVSI, a cone biopsy or hysterectomy with lymphadenectomy is recommended; the NCCN recommends modified radical hysterectomy, while ESMO recommends extrafascial hysterectomy. [8, 108]

According to the NCCN guidelines, postoperative pelvic radiation therapy (with or without concurrent cisplatin chemotherapy) is a category 1 recommendation for women with stage IA disease and negative lymph nodes after surgery who have high-risk cervical factors (eg, a large primary tumor, deep stromal invasion, and/or lymphovascular space invasion). [8]

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