What are the guidelines for treating stage IB or IIA cervical cancer?

Updated: Feb 12, 2019
  • Author: Cecelia H Boardman, MD; Chief Editor: Warner K Huh, MD  more...
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Answer

According to NCCN guidelines, fertility-sparing radical trachelectomy and pelvic lymph node dissection is an option only for stage IB1 with tumors ≤2 cm. However, fertility-sparing treatment is not recommended for stage IB1 small-cell neuroendocrine histology and adenoma malignum.10 ESMO guidelines recommend either radical trachelectomy or conization with/without chemotherapy are offered as a fertility-preserving option to stage IB1 patients. [55]

NCCN and ESMO non–fertility-sparing recommendations for stage IB or IIA are as follows [108] :

  • Radical hysterectomy and bilateral pelvic lymph node dissection: preferred for stages IB1 or IIA1; alternative treatment for stages IB2 or IIA2

  • Concurrent chemoradiation is the preferred treatment for stages IB2 or IIA2

  • Pelvic radiotherapy and brachytherapy with or without concurrent cisplatin-based chemotherapy is also acceptable for patients with stage IB1 or IIA1 disease

ESMO found no evidence that chemoradiation would be useful in patients with stages IB1 or IIA and tumors < 4 cm. [108]


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