中国抗癌协会妇科肿瘤专业委员会.子宫颈癌诊断与治疗指南(2021年版)[J].中国癌症杂志,2021,31(6):474-489.
子宫颈癌发病率居女性生殖系统恶性肿瘤第2位,根据世界卫生组织(WorldHealthOrganization,WHO)的数据,全球每年有新增病例53万,约25万女性因子宫颈癌死亡,其中发展中国家女性因子宫颈癌死亡人数占全球女性因子宫颈癌死亡人数的80%。在西方发达国家,由于人乳头瘤病毒(humanpapillomavirus,HPV)疫苗的使用和子宫颈癌筛查的普及,子宫颈癌发病率缓慢下降;在中国,每年新增子宫颈癌病例约14万,死亡病例约3.7万。
1
分期
1.1分期规则
1.2分期前检查
1.3临床分期
1.4影像分期
1.5手术分期
2
子宫颈癌病理类型
3
治疗
3.1基本原则
3.2子宫颈癌的手术治疗
3.3子宫颈癌放疗
3.4子宫颈癌的化疗
3.5各期子宫颈癌的治疗选择建议
3.6子宫颈癌根治术后辅助治疗
3.7复发性子宫颈癌的治疗
3.8妊娠期子宫颈癌的处理
3.9NECC的治疗
4
随访
4.1随访间隔
4.2随访内容
-----------END--------------
[参考文献]
OLAWAIYEAB,BAKERTP,WASHINGTONMK,etal.Thenew(version9)AmericanJointCommitteeonCancertumor,node,metastasisstagingforcervicalcancer[J].CACancerJClin,2021.Epubaheadofprint.
DELARAR,YANGJ,BUCKNER-PETTYS,etal.Surgicalorimaginglymphnodeassessmentinlocallyadvancedcervicalcancer:asystematicreviewandmeta-analysis[J].JGynecolOncol,2020,31(6):e79.
WHOClassificationoftumoursEditorialBoard.FemaleGenitalTumours.WHOClassificationofTumours,5thedition,vol.4[M].Lyon:IARCPress,2020:8.
MINIONLE,TEWARIKS.Cervicalcancer-stateofthescience:fromangiogenesisblockadetocheckpointinhibition[J].GynecolOncol,2018,148(3):609-621.
CHUNGHC,SCHELLENSJHM,DELORDJP,etal.Pembrolizumabtreatmentofadvancedcervicalcancer:updatedresultsfromthephase2KEYNOTE-158study[J].JClinOncol,2018,36(15_suppl):5522.
MARABELLEA,LEDT,ASCIERTOPA,etal.Efficacyofpembrolizumabinpatientswithnoncolorectalhighmicrosatelliteinstability/mismatchrepair-deficientcancer:resultsfromthephaseIIKEYNOTE-158study[J].JClinOncol,2020,38(1):1-10.
CIBULAD,ABU-RUSTUMNR,BENEDETTI-PANICIP,etal.Newclassificationsystemofradicalhysterectomy:emphasisonathree-dimensionalanatomictemplateforparametrialresection[J].GynecolOncol,2011,122(2):264-268.
RAMIREZPT,FRUMOVITZM,PAREJAR,etal.Minimallyinvasiveversusabdominalradicalhysterectomyforcervicalcancer[J].NEnglJMed,2018,379(20):1895-1904.
UPPALS,GEHRIGPA,PENGK,etal.Recurrenceratesinpatientswithcervicalcancertreatedwithabdominalversusminimallyinvasiveradicalhysterectomy:amulti-institutionalretrospectivereviewstudy[J].JClinOncol,2020,38(10):1030-1040.
WUYB,LIZM,WUHY,etal.Sentinellymphnodebiopsyincervicalcancer:ameta-analysis[J].MolClinOncol,2013,1(6):1025-1030.
KADKHODAYANS,HASANZADEHM,TREGLIAG,etal.Sentinelnodebiopsyforlymphnodalstagingofuterinecervixcancer:asystematicreviewandmeta-analysisofthepertinentliterature[J].EurJSurgOncol,2015,41(1):1-20.
FRUMOVITZM,PLANTEM,LEEPS,etal.TheFILMtrial:arandomizedphaseⅢmulticenterstudyassessingnearinfraredfluorescenceintheidentificationofsentinellymphnodes(SLN)[J].GynecolOncol,2018,149:7.
LIMK,SMALLWJr,PORTELANCEL,etal.Consensusguidelinesfordelineationofclinicaltargetvolumeforintensity-modulatedpelvicradiotherapyforthedefinitivetreatmentofcervixcancer[J].IntJRadiatOncolBiolPhys,2011,79(2):348-355.
SMALLWJr,BOSCHWR,HARKENRIDERMM,etal.NRGoncology/RTOGconsensusguidelinesfordelineationofclinicaltargetvolumeforintensitymodulatedpelvicradiationtherapyinpostoperativetreatmentofendometrialandcervicalcancer:anupdate[J].IntJRadiatOncolBiolPhys,2021,109(2):413-424.
KLOPPAH,YEUNGAR,DESHMUKHS,etal.Patient-reportedtoxicityduringpelvicintensity-modulatedradiationtherapy:NRGoncology-RTOG1203[J].JClinOncol,2018,36(24):2538-2544.
TAYLORA,ROCKALLAG,REZNEKRH,etal.Mappingpelviclymphnodes:guidelinesfordelineationinintensity-modulatedradiotherapy[J].IntJRadiatOncolBiolPhys,2005,63(5):1604-1612.
HIGGINSONDS,MORRISDE,JONESEL,etal.Stereotacticbodyradiotherapy(SBRT):technologicalinnovationandapplicationingynecologiconcology[J].GynecolOncol,2011,120(3):404-412.
LANDONIF,MANEOA,COLOMBOA,etal.RandomisedstudyofradicalsurgeryversusradiotherapyforstageⅠb-Ⅱacervicalcancer[J].Lancet,1997,350(9077):535-540.
WHITNEYCW,SAUSEW,BUNDYBN,etal.RandomizedcomparisonoffluorouracilpluscisplatinversushydroxyureaasanadjuncttoradiationtherapyinstageⅡB-ⅣAcarcinomaofthecervixwithnegativepara-aorticlymphnodes:aGynecologicOncologyGroupandSouthwestOncologyGroupstudy[J].JClinOncol,1999,17(5):1339-1348.
ROSEPG,BUNDYBN,WATKINSEB,etal.Concurrentcisplatin-basedradiotherapyandchemotherapyforlocallyadvancedcervicalcancer[J].NEnglJMed,1999,340(15):1144-1153.
KEYSHM,BUNDYBN,STEHMANFB,etal.Cisplatin,radiation,andadjuvanthysterectomycomparedwithradiationandadjuvanthysterectomyforbulkystageⅠBcervicalcarcinoma[J].NEnglJMed,1999,340(15):1154-1161.
MORRISM,EIFELPJ,LUJ,etal.Pelvicradiationwithconcurrentchemotherapycomparedwithpelvicandpara-aorticradiationforhigh-riskcervicalcancer[J].NEnglJMed,1999,340(15):1137-1143.
HUANGH,FENGYL,WANT,etal.Effectivenessofsequentialchemoradiationvsconcurrentchemoradiationorradiationaloneinadjuvanttreatmentafterhysterectomyforcervicalcancer:theSTARSphase3randomizedclinicaltrial[J].JAMAOncol,2021,7(3):361-369.
TRIFILETTIDM,SWISHER-MCCLURES,SHOWALTERTN,etal.Postoperativechemoradiationtherapyinhigh-riskcervicalcancer:re-evaluatingthefindingsofgynecologiconcologygroupstudy109inalarge,population-basedcohort[J].IntJRadiatOncolBiolPhys,2015,93(5):1032-1044.
KEYSHM,BUNDYBN,STEHMANFB,etal.RadiationtherapywithandwithoutextrafascialhysterectomyforbulkystageⅠBcervicalcarcinoma:arandomizedtrialoftheGynecologicOncologyGroup[J].GynecolOncol,2003,89(3):343-353.
KOKKAF,BRYANTA,BROCKBANKE,etal.Hysterectomywithradiotherapyorchemotherapyorbothforwomenwithlocallyadvancedcervicalcancer[J].CochraneDatabaseSystRev,2015(4):CD010260.
COLOMBOPE,BERTRANDMM,GUTOWSKIM,etal.Totallaparoscopicradicalhysterectomyforlocallyadvancedcervicalcarcinoma(stagesⅡB,ⅡAandbulkystagesⅠB)afterconcurrentchemoradiationtherapy:Surgicalmorbidityandoncologicalresults[J].GynecolOncol,2009,114(3):404-409.
TOUBOULC,UZANC,MAUGUENA,etal.Prognosticfactorsandmorbiditiesaftercompletionsurgeryinpatientsundergoinginitialchemoradiationtherapyforlocallyadvancedcervicalcancer[J].Oncologist,2010,15(4):405-415.
HUGUETF,COJOCARIUOM,LEVYP,etal.PreoperativeconcurrentradiationtherapyandchemotherapyforbulkystageⅠB2,ⅡA,andⅡBcarcinomaoftheuterinecervixwithproximalparametrialinvasion[J].IntJRadiatOncolBiolPhys,2008,72(5):1508-1515.
LEATHCA,STRAUGHNJM.Chemotherapyforadvancedandrecurrentcervicalcarcinoma:resultsfromcooperativegrouptrials[J].GynecolOncol,2013,129(1):251-257.
MCLACHLANJ,BOUSSIOSS,OKINESA,etal.Theimpactofsystemictherapybeyondfirst-linetreatmentforadvancedcervicalcancer[J].ClinOncol(RCollRadiol),2017,29(3):153-160.
MARTHC,LANDONIF,MAHNERS,etal.Cervicalcancer:ESMOclinicalpracticeguidelinesfordiagnosis,treatmentandfollow-up[J].AnnOncol,2018,29(Suppl4):iv262.
CIBULAD,PTTERR,PLANCHAMPF,etal.TheEuropeanSocietyofGynaecologicalOncology/EuropeanSocietyforRadiotherapyandOncology/EuropeanSocietyofPathologyguidelinesforthemanagementofpatientswithcervicalcancer[J].IntJGynecolCancer,2018,28(4):641-655.
SEDLISA,BUNDYBN,ROTMANMZ,etal.ArandomizedtrialofpelvicradiationtherapyversusnofurthertherapyinselectedpatientswithstageⅠBcarcinomaofthecervixafterradicalhysterectomyandpelviclymphadenectomy:aGynecologicOncologyGroupstudy[J].GynecolOncol,1999,73(2):177-183.
NOHJM,PARKW,KIMYS,etal.Comparisonofclinicaloutcomesofadenocarcinomaandadenosquamouscarcinomainuterinecervicalcancerpatientsreceivingsurgicalresectionfollowedbyradiotherapy:amulticenterretrospectivestudy(KROG13-10)[J].GynecolOncol,2014,132(3):618-623.
RYUSY,KIMMH,NAMBH,etal.Intermediate-riskgroupingofcervicalcancerpatientstreatedwithradicalhysterectomy:aKoreanGynecologicOncologyGroupstudy[J].BrJCancer,2014,110(2):278-285.
DIAZES,AOYAMAC,BAQUINGMA,etal.Predictorsofresidualcarcinomaorcarcinoma-in-situathysterectomyfollowingcervicalconizationwithpositivemargins[J].GynecolOncol,2014,132(1):76-80.
好文推荐
名师指导刻意练习
好医术服务号
扫码获取人工帮助
好医术小程序
看公开课,轻松高效学习
好医术APP
医生们的聚集地
欢迎您的咨询,期待为您服务!
好医术是一家临床医生教育机构,致力于成为医生在职学习的互联网第一品牌。经过四年的教学研发,形成了一套全新的执业医生技能教学体系,线上教育与线下练习并重,通过“测”“学”“练”“战”标准化流程打造医生学习闭环,未来将会帮助更多科室的更多医生学习与转变。