8.14. modified 2021 |
Consensus-based recommendation In stages IB1 and IIA1, treatment should be administered as follows: Surgery:
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If there are negative lymph nodes (pelvic) after surgical staging:
Radical hysterectomy with resection of the medial (near the uterus) half of the parametria, with an adequate safety margin and resection within healthy margins
(Piver II).
With a tumor-free resection margin at the vaginal cuff (IIA1).
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If the tumor is < 2 cm, with no risk factors:
Surgical staging with SNB and
Radical hysterectomy with resection of the medial (near the uterus) half of the parametria, with an adequate safety margin and resection within healthy margins
(Piver II).
With a tumor-free resection margin at the vaginal cuff (IIA1).
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If the patient is wishing to have children and the tumor is < 2 cm without risk factors:
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If family planning has been completed:
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If there are pelvic lymph-node metastases:
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In postmenopausal patients:
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In premenopausal patients:
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If there are pelvic and/or para-aortic lymph nodes macroscopically affected by tumor:
Radio(chemo)therapy:
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When there is histological evidence of pelvic and/or para-aortic lymph-node metastases, or several confirmed risk factors:
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If the patient is inoperable or requests it:
The radiation volume should be based on the anatomy and histologically confirmed lymph-node involvement.
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