ESGO-ESTRO-ESP Cervical Cancer Clinical Practice Guidelines Management of early stages: algorithms focusing on the histological data
|
|
- Darleen Carpenter
- 5 years ago
- Views:
Transcription
1 ESGO-ESTRO-ESP Cervical Cancer Clinical Practice Guidelines Management of early stages: algorithms focusing on the histological data David Cibula Gynecologic Oncology Centre General University Hospital in Prague Charles University David Cibula, VFN
2 Clinical staging Patients with cervical cancer should be staged according to the TNM classification!! based on a correlation of various diagnostic modalities (integrating physical examination, imaging and pathology) the method i.e. clinical (c), imaging (i) and or pathological (p) should be recorded David Cibula, VFN
3 Clinical staging Mandatory clinical and radiological diagnostic work-up Local work-up: Pelvic examination and biopsy Pelvic MRI OR endovaginal/transrectal ultrasound Nodal / distant work-up (LACC or suspicious LN): PET-CT or chest/abdomen CT David Cibula, VFN
4 David Cibula, VFN Tumor detection Tumor size measurements Stromal invasion depth Parametrial invasion Agreement with histology Agreement with histology Agreement with histology Agreement with histology Ultrasound vs MRI Ultrasound vs MRI Ultrasound vs MRI Ultrasound vs MRI 96 vs 86% 95 vs 93% 91 vs 88% 97 vs 90% P P=0.10 P=0.39 P Epstein E., Fischerova D. et al. Gynecol Oncol. 2013;128(3):
5 David Cibula, VFN T1a T1a Conisation Diagnosis should be based on a conisation specimen Margins neg (except for preinvasive ectocervix) Margins pos Re-conisation Final pathology T1a1 / T1a2
6 David Cibula, VFN T1a T1a1 LVSI neg. LVSI pos. FU FU SLN LVSI neg. T1a2 Conisation or SH is an adequate treatment LVSI pos. ± SLN ± SH SLN ± SH LN staging should be performed; SLN is adequate
7 David Cibula, VFN T1b1/T2a1 Treatment strategy should aim for the avoidance of combining radical surgery and radiotherapy due to the highest morbidity after combined treatment.
8 David Cibula, VFN Radical surgery OR Fertility sparing surgery LN + Adjuvant radiotherapy
9 David Cibula, VFN Radical surgery OR Fertility sparing surgery SLN LN + Adjuvant radiotherapy Radical surgery OR Fertility sparing surgery Primary radiotherapy
10 T1b1/T2a T1b1/T2a MRI / (US) LN neg. LN pos. Surgery RT CRT ± PALND David Cibula, VFN
11 T1b1/T2a Radical surgery by a gynecologic oncologist is the preferred modality (MIS) T1b1/T2a MRI / (US) LN neg. LN pos. Surgery RT CRT ± PALND David Cibula, VFN
12 Incidence of local-regional recurrence (%) Cumulative Local/Regional Recurrence HR: 4.26 (95% CI ), p=0.009 TLRH/TRRH TARH Number at risk TARH TLRH Years from randomization
13 T1b1/T2a - Surgery LN assessment should be performed as the 1st step. SLN is strongly recommended. SLN (LN) FS (S)LN neg or not done LN pos (MAC or MIC) PLND + RH Final histology ± PALND RH abandoned No further LN dissection CRT David Cibula, VFN
14 Barranger E IB1 IIB N = 33 Detection rate Side specific detection rate False negative rate Early stages N = 23 Locally advanced N = 10 86,9 % 67,4 % 0 80 % 55 % 20 % Annals of Oncol, 2005, 16, David Cibula, VFN
15 David Cibula, VFN Long spinal needle Application into the residual stroma Gynecol Oncol, 2009, 115, 46-50
16 David Cibula, VFN SLN detection rate in large tumors Pathologic largest tumour size p Detection rate 2 cm N= cm N=138 4 cm N=72 Unilateral 91% 97% 89% Bilateral 79% 83% 76% FNR if bilateral SLN detected 1% 1% 0% Gynecol Oncol Mar;148(3):
17 T1b1/T2a - Surgery SLN (LN) FS Intraoperative assessment of LN is recommended (SLN / LN / suspicious LN) (S)LN neg or not done LN pos (MAC or MIC) PLND + RH Final histology ± PALND RH abandoned No further LN dissection CRT David Cibula, VFN
18 Intraoperative SLN examination N = 225; IA2 IIB FS Final: ITC MIC MAC Negative = Positive = Sensitivity of FS: 0.56 (0.44;0.68) Gynecol Oncol, 2013, David Cibula, VFN
19 T1b1/T2a - Surgery SLN (LN) FS (S)LN neg or not done LN pos (MAC or MIC) PLND + RH Final histology ± PALND RH abandoned No further LN dissection CRT David Cibula, VFN
20 T1b1/T2a1 - Surgery SLN (LN) FS (S)LN neg or not done LN pos (MAC or MIC) PLND + RH Final histology ± PALND RH abandoned No further LN dissection CRT David Cibula, VFN
21 David Cibula, VFN SLN should be combined with systematic PLND (IB1) until results from prospective trials have confirmed its safety Unknown risk of LVD (small MAC) in non-sln Absence of universal protocol for SLN ultrastaging Limited prospective data available
22 David Cibula, VFN ENGOT-Cx 2 A prospective Phase II trial on sentinel lymph node biopsy in patients with early stage cervical cancer ENGOT model: A Sponsor(s): CEEGOG Planned No. of patients: 600 Countries participating: 18 Sites activated: 49 No. of already recruited patients: 300 Status: recruiting Timeline: 30/May/2016 (first patient recruited)
23 David Cibula, VFN Early stages SLN SENTICOL III Study type: RCT Leading group: GINECO Population: T1a1+LVSI T2a1 Primary objective: co-primary: DFS + Health Related QoL Description: SLN vs SLN + PLND 1:1; FS of SLN; Target group: 950 Expected completion: Q Current status: Recently opened
24 T1b1/T2a SLN (LN) FS (S)LN neg or not done LN pos (MAC or MIC) PLND + RH Final histology ± PALND RH abandoned No further LN dissection CRT David Cibula, VFN
25 David Cibula, VFN Querleu-Morrow classification (update 2017) Type of RH Lateral parametrium Ventral parametrium Dorsal parametrium Type A Halfway between cervix and ureter Minimal Type B1 At the ureteral bed Partial excision of the vesicouterine lig Minimal Partial excision of the recto-uterine/-vaginal lig Type B2 B1 + paracervical LND B1 B1 Type C1 At the iliac vessels transversally, at the uterine vein horizontally Excision of the vesicouterine lig (cranial to the ureter) Type C2 C1 + caudal part At the bladder (incl. vesico-vaginal lig) At the rectum (hypogastric nerve is spared) At the sacrum
26 David Cibula, VFN Risk groups according to prognostic factors and suggested type of radical hysterectomy Risk group Tumor size LVSI Stromal invasion Type of rad hyst LR 2 cm Neg Inner 1/3 B1 (A) IR 2 cm Neg Any B2 (C1) 2 cm Pos Any HR 2 cm Pos Any C1 (C2)
27 T1b1/T2a Final histology ` SLN pathologic ultrastaging increases staging accuracy, namely the identification of MIC and small MAC LN pos (MAC or MIC) OR Parametria pos OR Vaginal margins pos Adjuvant (C)RT David Cibula, VFN
28 Retrospective study, , stage IB1-IIA pn0 + no adjuvant treatment N=83; Recurrence rate = 18% ultrastaging of ALL LN Variable OR P value pn1 mic Stromal invasion 2/ Tumor size ( 2 cm ) LVSI Int J Gyn Obst 2016, 133, David Cibula, VFN
29 8 centres Inclusion criteria IA2 IIB Histology (S, A, AS) SLN + ultrastaging PLND FU data Gynecol Oncol, 2012, 124, N = 645 FU (median) 40 mo (1 116) Age (median) 46 y (23 93) Cell type Stage Adeno 25 % Squamo 75 % IB1 74 % IB2-IIB 17 % David Cibula, VFN
30 Proportion of surviving Overall survival 1,0 Neg 0,9 0,8 p<0.001 MIC MAC 0,7 0, Time (months) Mutual comparison of categories (p values): ITC Micro-met. Macro-met. Negative <0.001 <0.001 ITC Micro-met ITC Negative Micro-metastases Macro-metastases
31 David Cibula, VFN SLN ultrastaging Entire SLN should be analyzed Each section should be stained by both H E and cytokeratin Intervals between sections? ( m)
32 Sensitivity IA2 IIB; N = 645; 8 centers FU (median) 40 mo (1 116) SLN (ultrastaging) PLND SLN ultrastaging Pelvic non-sln N (%) Neg Neg 438 (68%) Neg Mac 18 (2.8%) ITC (4); MIC (19) MAC 23 (3.6%) = FNR Pos Neg 118 (18.3%) MAC MAC 48 (18.3%) Gynecol Oncol, 2012, 124, David Cibula, VFN
33 David Cibula, VFN N=645; at least unilateral SLN detection Pelvic LN status SLN status SLN sensitivity Positive N=41 Positive (any type) N=18 91%
34 Sensitivity IA2 IIB; N = 645; 8 centers FU (median) 40 mo (1 116) SLN (ultrastaging) PLND SLN ultrastaging Pelvic non-sln N (%) Neg Neg 438 (68%) Neg Mac 18 (2.8%) ITC (4); MIC (19) MAC 23 (3.6%) = FNR Pos Neg 118 (18.3%) MAC MAC 48 (18.3%) Gynecol Oncol, 2012, 124, David Cibula, VFN
35 David Cibula, VFN N=645; at least unilateral SLN detection Pelvic LN status SLN status SLN sensitivity Positive N=41 Positive (any type) N=18 91% Positive for MAC N=23 80%!!!
36 David Cibula, VFN Detection of LVSI from biopsy Intraoperative LN / SLN evaluation SLN ultrastaging Assessment of tumor related prognostic risk factors (LVSI, stromal invasion, tumor size)
37 3 7 David Cibula, VFN
Enterprise Interest None
Enterprise Interest None Cervical Cancer -Management of late stages ESP meeting Bilbao Spain 2018 Dr Mary McCormack PhD FRCR Consultant Clinical Oncologist University College Hospital London On behalf
More informationSLN Mapping in Cervical Cancer. Memorial Sloan Kettering Cancer Center New York, USA
Lead Grou p Log SLN Mapping in Cervical Cancer Nadeem R. Abu-Rustum, M.D. Memorial Sloan Kettering Cancer Center New York, USA Conflict of Interest Disclosure Nadeem R. Abu-Rustum, M.D. I have no financial
More informationCervical Cancer: 2018 FIGO Staging
Cervical Cancer: 2018 FIGO Staging Jonathan S. Berek, MD, MMS Laurie Kraus Lacob Professor Stanford University School of Medicine Director, Stanford Women s Cancer Center Senior Scientific Advisor, Stanford
More informationGynecologic Cancer InterGroup Cervix Cancer Research Network. The SHAPE Trial
Gynecologic Cancer InterGroup Cervix Cancer Research Network The SHAPE Trial Comparing radical hysterectomy and pelvic node dissection against simple hysterectomy and pelvic node dissection in patients
More informationCervical Cancer 3/25/2019. Abnormal vaginal bleeding
Cervical Cancer Abnormal vaginal bleeding Postcoital, intermenstrual or postmenopausal Vaginal discharge Pelvic pain or pressure Asymptomatic In most patients who are not sexually active due to symptoms
More informationUpdate on Sentinel Node Biopsy in Endometrial Cancer: Feasibility, Technique, Impact
Update on Sentinel Node Biopsy in Endometrial Cancer: Feasibility, Technique, Impact Bjørn Hagen, MD, PhD St Olavs Hospital Trondheim University Hospital Trondheim, Norway Endometrial Cancer (EC) The most
More informationStaging and Treatment Update for Gynecologic Malignancies
Staging and Treatment Update for Gynecologic Malignancies Bunja Rungruang, MD Medical College of Georgia No disclosures 4 th most common new cases of cancer in women 5 th and 6 th leading cancer deaths
More informationRole of Surgery in Cervical Cancer & Research Questions
Role of Surgery in Cervical Cancer & Research Questions Arb-aroon Lertkhachonsuk, M.D., Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand Role of surgery in cervical cancer
More informationRole and Techniques of Surgery in Carcinoma Cervix. Dr Vanita Jain Additional Professor OBGYN PGIMER, Chandigarh
Role and Techniques of Surgery in Carcinoma Cervix Dr Vanita Jain Additional Professor OBGYN PGIMER, Chandigarh Points for Discussion Pattern of spread Therapeutic options Types of surgical procedures
More informationNorth of Scotland Cancer Network Clinical Management Guideline for Carcinoma of the Uterine Cervix
THIS DOCUMENT North of Scotland Cancer Network Carcinoma of the Uterine Cervix UNCONTROLLED WHEN PRINTED DOCUMENT CONTROL Prepared by A Kennedy/AG Macdonald/Others Approved by NOT APPROVED Issue date April
More informationStaging. Carcinoma confined to the corpus. Carcinoma confined to the endometrium. Less than ½ myometrial invasion. Greater than ½ myometrial invasion
5 th of June 2009 Background Most common gynaecological carcinoma in developed countries Most cases are post-menopausal Increasing incidence in certain age groups Increasing death rates in the USA 5-year
More informationUPDATE IN THE MANAGEMENT OF INVASIVE CERVICAL CANCER
UPDATE IN THE MANAGEMENT OF INVASIVE CERVICAL CANCER Susan Davidson, MD Professor Department of Obstetrics and Gynecology Division of Gynecologic Oncology University of Colorado- Denver Anatomy Review
More informationCervical Cancer Guidelines L and SC Network July Introduction:
Cervical Cancer Guidelines L and SC Network July 2018 Introduction: There was a total number of 442 cases of cervix cancer diagnosed in Lancashire and South Cumbria Cancer Network in the period 2005 2009
More informationof surgical management of early invasive cervical cancer chapter Diagnosis and staging Wertheim described the principles
chapter 14. Surgical management of early invasive cervical cancer CHAPTER 1 Wertheim described the principles of surgical management of invasive cervical cancer more than 100 years ago in his treatise
More informationMRI in Cervix and Endometrial Cancer
28th Congress of the Hungarian Society of Radiologists RCR Session Budapest June 2016 MRI in Cervix and Endometrial Cancer DrSarah Swift St James s University Hospital Leeds, UK Objectives Cervix and endometrial
More informationThe Role of Radiation in the Management of Gynecologic Cancers. Scott Glaser, MD
The Role of Radiation in the Management of Gynecologic Cancers Scott Glaser, MD Nothing to disclose DISCLOSURE Outline The role of radiation in: Endometrial Cancer Adjuvant Medically inoperable Cervical
More informationPRINCESS MARGARET CANCER CENTRE CLINICAL PRACTICE GUIDELINES GYNECOLOGIC CANCER CERVIX
PRINCESS MARGARET CANCER CENTRE CLINICAL PRACTICE GUIDELINES GYNECOLOGIC CANCER CERVIX Site Group: Gynecology Cervix Author: Dr. Stephane Laframboise 1. INTRODUCTION 3 2. PREVENTION 3 3. SCREENING AND
More informationA phase II study of weekly paclitaxel and cisplatin followed by radical hysterectomy in stages IB2 and IIA2 cervical cancer AGOG14-001/TGOG1008
A phase II study of weekly paclitaxel and cisplatin followed by radical hysterectomy in stages IB2 and IIA2 cervical cancer AGOG14-001/TGOG1008 NCT02432365 Chyong-Huey Lai, MD On behalf of Principal investigator
More informationSession Number: 1020 Session: Adenocarcinoma of the Cervix: Diagnostic Pitfalls and New Prognostic Implications. Andres A. Roma, MD Cleveland Clinic
Session Number: 1020 Session: Adenocarcinoma of the Cervix: Diagnostic Pitfalls and New Prognostic Implications Andres A. Roma, MD Cleveland Clinic No Disclosures In the past 12 months, I have not had
More informationPre-operative Evaluation and Implications
Pre-operative Evaluation and Implications Michal Zikan Gynecologic Oncology Center Charles University in Prague, First Faculty of Medicine No recommendation for screening of EC (HNPCC annual biopsies starting
More informationMelanoma Quality Reporting
Melanoma Quality Reporting September 1, 2013 December 31, 2016 Laurence McCahill, MD Surgical Oncologist Metro Health Surgical Oncology Metro Health Professional Building 2122 Health Drive SW Wyoming,
More informationIndication for Surgery in Endometrial & Cervical Cancer. everything you need to know in 30 minutes!!! Fabio Landoni, MD Gynecologic Department
Indication for Surgery in Endometrial & Cervical Cancer everything you need to know in 30 minutes!!! Fabio Landoni, MD Gynecologic Department Risk Factors LVSI Myometrial invasion Nodes grade Adjuvant
More informationServiks Kanserinde radikal cerrahide sinir koruyucu yaklaşım
Serviks Kanserinde radikal cerrahide sinir koruyucu yaklaşım Prof. Dr. Hüsnü Çelik Başkent Üniversitesi Tıp Fakulesi Jinekolojik Onkoloji Bölümü (Adana Yerleşkesi) Maximal oncological control Minimal early
More informationGUIDELINE PAPER. Virchows Archiv (2018) 472:
Virchows Archiv (2018) 472:919 936 https://doi.org/10.1007/s00428-018-2362-9 GUIDELINE PAPER The European Society of Gynaecological Oncology/European Society for Radiotherapy and Oncology/European Society
More informationCoversheet for Network Site Specific Group Agreed Documentation
Coversheet for Network Site Specific Group Agreed Documentation This sheet is to accompany all documentation agreed by Pan Birmingham Cancer Network Site Specific Groups. This will assist the Network Governance
More informationMRI for cervical and endometrial cancers. Dr Robert Bleehen Consultant Radiologist Cardiff & Vale UHB
MRI for cervical and endometrial cancers Dr Robert Bleehen Consultant Radiologist Cardiff & Vale UHB RCR 06(1) RCR 06(1) Technique Pelvic multiphased-array coil Fasting? Buscopan? ABDOMEN!!! Cx:+/- HR
More informationAlgorithms for management of Cervical cancer
Algithms f management of Cervical cancer Algithms f management of cervical cancer are based on existing protocols and guidelines within the ESGO comunity and prepared by ESGO Educational Committe as a
More informationLocally advanced disease & challenges in management
Gynecologic Cancer InterGroup Cervix Cancer Research Network Cervix Cancer Education Symposium, February 2018 Locally advanced disease & challenges in management Carien Creutzberg Radiation Oncology, Leiden
More informationManagement of high risk early cervical cancer - a view of surgeon Dan DY Kim, M.D., Ph.D.
Management of high risk early cervical cancer - a view of surgeon Dan DY Kim, M.D., Ph.D. Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
More informationCorrelation of intermediate risk factors with prognostic factors in patients with early cervical cancer
대한부인종양콜포스코피학회제 24 차학술대회 Correlation of intermediate risk factors with prognostic factors in patients with early cervical cancer Seoul National University Bundang Hospital Eun Jung Soh, M.D. Cervical cancer
More informationUpdate on Neoadjuvant Chemotherapy (NACT) in Cervical Cancer
Update on Neoadjuvant Chemotherapy (NACT) in Cervical Cancer Nicoletta Colombo, MD University of Milan-Bicocca European Institute of Oncology Milan, Italy NACT in Cervical Cancer NACT Stage -IB2 -IIA>4cm
More informationCervixcancer. Vad är aktuellt? Jan Persson. Lund. Docent överläkare Dep of OB&G Skane univ hosp Lund Sweden
Cervixcancer Copyright Jan Persson Lund Vad är aktuellt? Jan Persson Docent överläkare Dep of OB&G Skane univ hosp Lund Sweden Controversies Preop selection related stage ( stage 1b1>= 2 cm) Neoadjuvant
More informationhttps://patient.varian.com/sit es/default/files/videos/origin al/imrt.mp4 brachy- from Greek brakhys "short" Historically LDR has been used. Cs-137 at 0.4-0.8 Gy/h With optimally placed device, dose
More informationDisclosure. No Conflicts of Interest
Phase III Randomized Trial of Laparoscopic or Robotic Radical Hysterectomy vs. Abdominal Radical Hysterectomy in Patients with Early-Stage Cervical Cancer: LACC Trial Pedro T. Ramirez, Michael Frumovitz,
More informationInternational prospective validation trial of sentinel node biopsy in cervical cancer
Cervix cancer committee International prospective validation trial of sentinel node biopsy in cervical cancer N Abu-Rustum, F Lécuru, P Mathevet, M Plante. F Bonnetain (Statistics) G Chatellier (Clinical
More informationTranslating Evidence into Practice: Primary Cutaneous Melanoma Guidelines. Sentinel Lymph Node Biopsy
American Academy of Dermatology 2018 Annual Meeting San Diego, CA, February 17, 2018 Translating Evidence into Practice: Primary Cutaneous Melanoma Guidelines. Sentinel Lymph Node Biopsy Christopher Bichakjian,
More informationSentinel Lymph Node in Endometrial Cancer. Reem Abdallah, MD American University of Beirut Medical Center
Sentinel Lymph Node in Endometrial Cancer Reem Abdallah, MD American University of Beirut Medical Center No disclosures Percent of Cases by Stage 8% 4% 21% 67% Localized (confined to primary site) Regional
More informationWhat We Have Learned from Over 1400 Radical Hysterectomy Operations in Chiang Mai University Hospital
Thai Journal of Obstetrics and Gynaecology April 2008, Vol. 16, pp. 79-8561-167 SPECIAL ARTICLE What We Have Learned from Over 1400 Radical Hysterectomy Operations in Chiang Mai University Hospital Jatupol
More information17 th ESO-ESMO Masterclass in clinical Oncology
17 th ESO-ESMO Masterclass in clinical Oncology Cervical and endometrial Cancer Cristiana Sessa IOSI Bellinzona, Switzerland Berlin, March 28 th, 2018 Presenter Disclosures None Cervical Cancer Estimated
More informationCervical cancer presentation
Carcinoma of the cervix: Carcinoma of the cervix is the second commonest cancer among women worldwide, with only breast cancer occurring more commonly. Worldwide, cervical cancer accounts for about 500,000
More informationreceive adjuvant chemotherapy
Women with high h risk early stage endometrial cancer should receive adjuvant chemotherapy Michael Friedlander The Prince of Wales Cancer Centre and Royal Hospital for Women The Prince of Wales Cancer
More informationProposed All Wales Vulval Cancer Guidelines. Dr Amanda Tristram
Proposed All Wales Vulval Cancer Guidelines Dr Amanda Tristram Previous FIGO staging FIGO Stage Features TNM Ia Lesion confined to vulva with
More informationECC or Margins Positive?
CLINICAL PRESENTATION This practice algorithm has been specifically developed for M. D. Anderson using a multidisciplinary approach and taking into consideration circumstances particular to M. D. Anderson,
More informationIntention-to-Treat Analysis of Radical Trachelectomy for Early-Stage Cervical Cancer With Special Reference to Oncologic Failures
ORIGINAL STUDY Intention-to-Treat Analysis of Radical Trachelectomy for Early-Stage Cervical Cancer With Special Reference to Oncologic Failures Single-Institutional Experience in Hungary Robert Póka,
More informationUterus Malignancies /5/15
Collecting Cancer Data: Uterus 2014-2015 NAACCR Webinar Series February 5, 2015 Q&A Please submit all questions concerning webinar content through the Q&A panel. Reminder: If you have participants watching
More informationCervical Cancer Pocket Guidelines
ervical ancer Pocket Guidelines guidelines.esgo.org vical_cancer_guidelines_a6_c.indd 1 23.3.18 15:1 2 vical_cancer_guidelines_a6_c.indd 2 23.3.18 15:1 POKET GUIDELINES ERVIAL ANER based on ESGO-ESTRO-ESP
More informationGynecologic Cancer InterGroup Cervix Cancer Research Network. Management of Cervical Cancer in Resource Limited Settings.
Management of Cervical Cancer in Resource Limited Settings Linus Chuang MD Conflict of Interests None Cervical cancer is the fourth most common malignancy in women worldwide 530,000 new cases per year
More informationRole and extension of lymph node dissection in kidney, bladder and prostate cancer. Omar Ghanem (PGY3 ) Moderator: Dr A. Noujem 30 th March 2017
Role and extension of lymph node dissection in kidney, bladder and prostate cancer Omar Ghanem (PGY3 ) Moderator: Dr A. Noujem 30 th March 2017 Bladder Cancer LN dissection in Bladder cancer 25% of patients
More informationPara-aortic laparoscopic lymph-node dissection for advanced cervical cancers
Para-aortic laparoscopic lymph-node dissection for advanced cervical cancers P. Mathevet, Hôpital Femme-Mère-Enfant, Bron Lymph-node involvement Is one of the major prognostic factor in gynecologic cancers.
More informationManagement and Care of Women with Invasive Cervical Cancer: American Society of Clinical Oncology Resource-Stratified Clinical Practice Guideline
Management and Care of Women with Invasive Cervical Cancer: American Society of Clinical Oncology Resource-Stratified Clinical Practice Guideline www.asco.org/rs-cervical-cancer-treatment-guideline Introduction
More informationCzech Republic. Serbia Belarus
Czech Republic Slovakia Romania Ukraine Hungary Croatia Georgia Czech Republic Serbia Belarus Slovakia Hungary Slovenia Macedonia CEEGOG INTRODUCTION CEEGOG Central and Eastern European Gynecology Oncology
More informationWe are IntechOpen, the world s leading publisher of Open Access books Built by scientists, for scientists. International authors and editors
We are IntechOpen, the world s leading publisher of Open Access books Built by scientists, for scientists 3,800 116,000 120M Open access books available International authors and editors Downloads Our
More informationBreast Surgery When Less is More and More is Less. E MacIntosh, MD June 6, 2015
Breast Surgery When Less is More and More is Less E MacIntosh, MD June 6, 2015 Presenter Disclosure Faculty: E. MacIntosh Relationships with commercial interests: None Mitigating Potential Bias Not applicable
More informationChapter 2: Initial treatment for endometrial cancer (including histologic variant type)
Chapter 2: Initial treatment for endometrial cancer (including histologic variant type) CQ01 Which surgical techniques for hysterectomy are recommended for patients considered to be stage I preoperatively?
More informationAdjuvant Therapies in Endometrial Cancer. Emma Hudson
Adjuvant Therapies in Endometrial Cancer Emma Hudson Endometrial Cancer Most common gynaecological cancer Incidence increasing in Western world 1-2% cancer deaths 75% patients postmenopausal 97% epithelial
More informationPrognosis and recurrence pattern of patients with cervical carcinoma and pelvic lymph node metastasis
NJOG 2009 June-July; 4 (1): 19-24 Prognosis and recurrence pattern of patients with cervical carcinoma and pelvic lymph node metastasis Eliza Shrestha 1, Xiong Ying 1,2, Liang Li-Zhi 1,2, Zheng Min 1,2,
More informationIntra-operative frozen section analysis of common iliac lymph nodes in patients with stage IB1 and IIA1 cervical cancer
Arch Gynecol Obstet (2012) 285:811 816 DOI 10.1007/s00404-011-2038-z GYNECOLOGIC ONCOLOGY Intra-operative frozen section analysis of common iliac lymph nodes in patients with stage IB1 and IIA1 cervical
More informationInfluence of Lymphadenectomy on Survival for Early-Stage Endometrial Cancer
Influence of Lymphadenectomy on Survival for Early-Stage Endometrial Cancer Jason D. Wright, MD, Yongemei Huang, MD/PhD, William M. Burke, MD, et al. Journal Club March 16, 2016 Blaine Campbell-PGY2 Objective
More informationProstate Case Scenario 1
Prostate Case Scenario 1 H&P 5/12/16: A 57-year-old Hispanic male presents with frequency of micturition, urinary urgency, and hesitancy associated with a weak stream. Over the past several weeks, he has
More informationRochester Minnesota Mayo Clinic
Are There Still Indications for Lymphadenectomy in Endometrial Cancer? A Mariani Mayo Clinic Rochester - MN USA Rochester Minnesota Mayo Clinic 1 Endometrial Cancer Lymphadenectomy Yes or No? Endometrial
More informationsurgical staging g in early endometrial cancer
Risk adapted d approach to surgical staging g in early endometrial cancer Leon Massuger University Medical Centre St Radboud Nijmegen, The Netherlands Doing nodes Yes Yes Yes No No No 1957---------------------------
More informationFertility-sparing surgery in young patients with cervical cancer
Fertility-sparing surgery in young patients with cervical cancer Pr Catherine Uzan Chef de service Chirurgie et cancérologie gynécologique et mammaire, Pitié Evaluation BEFORE surgery Cancer: stage, type
More informationEvolving Treatment Strategies for Cervical Cancer
Evolving Treatment Strategies for Cervical Cancer Nadeem Abu-Rustum, MD Memorial Sloan Kettering Cancer Center Evolving Treatment Strategies 1. Surgery 2. Radiation 3. Chemotherapy Incidence of cervix
More informationMost common cancer Africans & Asians more prone because of poor socioeconomic condition Drastic decline in west as more detection of preinvasive
CANCER CERVIX Most common cancer Africans & Asians more prone because of poor socioeconomic condition Drastic decline in west as more detection of preinvasive leison by PAP Smears. Etiology: Age - 2 peaks
More informationCase Scenario 1 Worksheet. Primary Site C44.4 Morphology 8743/3 Laterality 0 Stage/ Prognostic Factors
CASE SCENARIO 1 9/10/13 HISTORY: Patient is a 67-year-old white male and presents with lesion located 4-5cm above his right ear. The lesion has been present for years. No lymphadenopathy. 9/10/13 anterior
More informationJacqui Morgan March 6, 2019
Jacqui Morgan March 6, 2019 Case 1 25yo, G2P1 Here for WWE, no problems, healthy, needs refill on OCPs. Pap- Abnormal Glandular Cells-NOS Now What?? Case 1 Colposcopy What findings? Case 1 ECC Cervical
More informationGYN GEC-ESTRO/ICRU 89 Target Concept. Richard Pötter Medical University Vienna
GYN GEC-ESTRO/ICRU 89 Target Concept Richard Pötter Medical University Vienna GYN GEC ESTRO RECOMMENDATIONS-BACKGROUND From 2D to 3D/4D Historical difficulties in communicating results of cervical BT due
More information6. Cervical Lymph Nodes and Unknown Primary Tumors of the Head and Neck
1 Terms of Use The cancer staging form is a specific document in the patient record; it is not a substitute for documentation of history, physical examination, and staging evaluation, or for documenting
More informationInvasive Cervical Cancer: Squamous Cell, Adenocarcinoma, Adenosquamous
Note: If available, clinical trials should be considered as preferred treatment options for eligible patients (www.mdanderson.org/gynonctrials). Other co-morbidities are taken into consideration prior
More informationHistory and Classification of Radical Hysterectomy. Korea University Jae Yun Song
History and Classification of Radical Hysterectomy Korea University Jae Yun Song Contents Introduction History of radical hysterectomy Classification of radical hysterectomy Introduction Hysterectomy Hystera
More informationThe Role of Sentinel Lymph Node Biopsy and Axillary Dissection
The Role of Sentinel Lymph Node Biopsy and Axillary Dissection Henry Mark Kuerer, MD, PhD, FACS Department of Surgical Oncology University of Texas MD Anderson Cancer Center SLN Biopsy Revolutionized surgical
More informationPET/CT in Gynaecological Cancers. Stroobants Sigrid, MD, PhD Departement of Nuclear Medicine University Hospital,Antwerp
PET/CT in Gynaecological Cancers Stroobants Sigrid, MD, PhD Departement of Nuclear Medicine University Hospital,Antwerp Cervix cancer Outline of this talk Initial staging Treatment monitoring/guidance
More informationCervical Cancer. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines ) Version NCCN.org. Continue
NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines ) Version 1.2015 NCCN.org Continue Version 1.2015, 08/07/14 National Comprehensive Cancer Network, Inc. 2014, All rights reserved. The NCCN
More informationSCBT.MR MRI of Uterine Malignancy. Susan M. Ascher, MD, FSCBT.MR Georgetown University School of Medicine Washington, DC
2 0 1 6 SCBT.MR MRI of Uterine Malignancy Susan M. Ascher, MD, FSCBT.MR Georgetown University School of Medicine Washington, DC aschers@gunet.georgetown.edu MUST READS Sala E, et al. The added role of
More informationPrinciples of breast radiation therapy
ANZ 1601/BIG 16-02 EXPERT ESMO Preceptorship Program 2017 Principles of breast radiation therapy Boon H Chua Professor Director of Cancer and Haematology Services UNSW Sydney and Prince of Wales Hospital
More informationAdjuvant Chemotherapy in High Risk Patients after Wertheim Hysterectomy 10-year Survivals
6 Adjuvant Chemotherapy in High Risk Patients after Wertheim Hysterectomy 0-year Survivals V Sivanesaratnam,*FAMM, FRCOG, FACS Abstract Although the primary operative mortality following radical hysterectomy
More informationNorth of Scotland Cancer Network Clinical Management Guideline for Endometrial Cancer
THIS DOCUMENT North of Scotland Cancer Network Clinical Management Guideline for Endometrial Cancer Based on WOSCAN CMG with further extensive consultation within NOSCAN UNCONTROLLED WHEN PRINTED DOCUMENT
More informationFDG-PET/CT in Gynaecologic Cancers
Friday, August 31, 2012 Session 6, 9:00-9:30 FDG-PET/CT in Gynaecologic Cancers (Uterine) cervical cancer Endometrial cancer & Uterine sarcomas Ovarian cancer Little mermaid (Edvard Eriksen 1913) honoring
More informationCase Scenario 1 History and Physical 3/15/13 Imaging Pathology
Case Scenario 1 History and Physical 3/15/13 The patient is an 84 year old white female who presented with an abnormal mammogram. The patient has a five year history of refractory anemia with ringed sideroblasts
More informationNewton Wellesley Hospital 2013
Newton Wellesley Hospital 20 Standard 4.6 Assessment and Evaluation of Treatment Planning Endometrial Cancer Each year a physician member of the cancer committee conducts a study to ensure that diagnostic
More informationOncologic effectiveness of nerve-sparing radical hysterectomy in cervical cancer
J Gynecol Oncol. 2018 May;29(3):e41 pissn 2005-0380 eissn 2005-0399 Original Article Oncologic effectiveness of nerve-sparing radical hysterectomy in cervical cancer Antonino Ditto, Giorgio Bogani, Umberto
More informationSTAGE CATEGORY DEFINITIONS
CLINICAL Extent of disease before any treatment y clinical staging completed after neoadjuvant therapy but before subsequent surgery TX Tis Tis (DCIS) Tis (LCIS) Tis (Paget s) T1 T1mi T1a T1b T1c a b c
More informationCervical cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up
Annals of Oncology 28 (Supplement 4): iv72 iv83, 2017 doi:10.1093/annonc/mdx220 CLINICAL PRACTICE GUIDELINES Cervical cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up C.
More informationCARCINOMA CERVIX. Dr. PREETHI REDDY. B. M S OBG II yr POST GRADUATE.
CARCINOMA CERVIX Dr. PREETHI REDDY. B M S OBG II yr POST GRADUATE. Introduction Cervical cancer is the second most common female malignancy worldwide. It is responsible for 4,66,000 deaths annually worldwide
More informationGuideline for the Management of Vulval Cancer
Version History Guideline for the Management of Vulval Cancer Version Date Brief Summary of Change Issued 2.0 20.02.08 Endorsed by the Governance Committee 2.1 19.11.10 Circulated at NSSG meeting 2.2 13.04.11
More informationICRT รศ.พญ.เยาวล กษณ ชาญศ ลป
ICRT รศ.พญ.เยาวล กษณ ชาญศ ลป Brachytherapy การร กษาด วยร งส ระยะใกล Insertion การสอดใส แร Implantation การฝ งแร Surface application การวางแร physical benefit of brachytherapy - very high dose of radiation
More informationPrognostic significance of positive lymph node number in early cervical cancer
1052 Prognostic significance of positive lymph node number in early cervical cancer JUNG WOO PARK and JONG WOON BAE Department of Obstetrics and Gynecology, Dong A University Hospital, Dong A University
More informationCPC on Cervical Pathology
CPC on Cervical Pathology Dr. W.K. Ng Senior Medical Officer Department of Clinical Pathology Pamela Youde Nethersole Eastern Hospital Cervical Smear: High Grade SIL (CIN III) Cervical Smear: High Grade
More informationEvolution of radical hysterectomy for cervical cancer along the last two decades: single institution experience
Original Article on Cervical Cancer Evolution of radical hysterectomy for cervical cancer along the last two decades: single institution experience Claudia Arispe, Ana Isabel Pomares, Javier De Santiago,
More informationNew Cancer Cases By Site Breast 28% Lung 14% Colo-Rectal 10% Uterus 6% Thyroid 5% Lymphoma 4% Ovary 3%
Uterine Malignancy New Cancer Cases By Site 2010 Breast 28% Lung 14% Colo-Rectal 10% Uterus 6% Thyroid 5% Lymphoma 4% Ovary 3% Cancer Deaths By Site 2010 Lung 26% Breast 15% Colo-Rectal 9% Pancreas 7%
More informationVulvar Carcinoma. Definition: Cases should be classified as carsinoma of the vulva when the primary site growth is in the vulva Malignant melanoma sho
Carcinoma Vulva & Vagina Subdivisi Onkologi Ginekologi Bagian Obgin FK USU Vulvar Carcinoma. Definition: Cases should be classified as carsinoma of the vulva when the primary site growth is in the vulva
More informationStage IB1 (2-4 cm) Cervical cancer treated with Neoadjuvant chemotherapy followed by fertility Sparing Surgery (CONTESSA) Dre Marie Plante
Stage IB1 (2-4 cm) Cervical cancer treated with Neoadjuvant chemotherapy followed by fertility Sparing Surgery (CONTESSA) Dre Marie Plante Neo-Adjuvant Chemotherapy and Conservative Surgery in Cervical
More information2009 USCAP Gyn Pathology Evening Session Case #3. Richard J. Zaino, MD Hershey Medical Center Penn State University Hershey, PA
2009 USCAP Gyn Pathology Evening Session Case #3 Richard J. Zaino, MD Hershey Medical Center Penn State University Hershey, PA rzaino@psu.edu Clinical history Middle aged woman with an exophytic mass of
More informationUterine Cervix. Protocol applies to all invasive carcinomas of the cervix.
Uterine Cervix Protocol applies to all invasive carcinomas of the cervix. Protocol revision date: January 2005 Based on AJCC/UICC TNM, 6 th edition and FIGO 2001 Annual Report Procedures Cytology (No Accompanying
More informationENDOMETRIAL CANCER. Endometrial cancer is a great concern in UPDATE. For personal use only. Copyright Dowden Health Media
For mass reproduction, content licensing and permissions contact Dowden Health Media. UPDATE ENDOMETRIAL CANCER Are lymphadenectomy and external-beam radiotherapy valuable in women who have an endometrial
More informationChapter 8 Adenocarcinoma
Page 80 Chapter 8 Adenocarcinoma Overview In Japan, the proportion of squamous cell carcinoma among all cervical cancers has been declining every year. In a recent survey, non-squamous cell carcinoma accounted
More informationProspective Study of Sentinel Lymph Node Biopsy Without Further Pelvic Lymphadenectomy in Patients With Sentinel Lymph NodeYNegative Cervical Cancer
ORIGINAL STUDY Prospective Study of Sentinel Lymph Node Biopsy Without Further Pelvic Lymphadenectomy in Patients With Sentinel Lymph NodeYNegative Cervical Cancer Hitoshi Niikura, MD,* Satoshi Okamoto,
More information3/23/2017. Disclosure of Relevant Financial Relationships. Pathologic Staging Updates in Breast Cancer. Pathologic Staging Updates Breast Cancer
Pathologic Staging Updates in Breast Cancer Disclosure of Relevant Financial Relationships USCAP requires that all planners (Education Committee) in a position to influence or control the content of CME
More informationCase Scenario 1. 7/13/12 Anterior floor of mouth biopsy: Infiltrating squamous cell carcinoma, not completely excised.
Case Scenario 1 7/5/12 History A 51 year old white female presents with a sore area on the floor of her mouth. She claims the area has been sore for several months. She is a current smoker and user of
More informationQuimio Radioterapia en Cancer de Cervix
Quimio Radioterapia en Cancer de Cervix HIGINIA R. CÁRDENES PROFESSOR RADIATION ONCOLOGY CLINICAL DIRECTOR SCHNECK CANCER CENTER Worldwide incidence of cervical cancer 2014, 12.360 cases Global incidence
More information