Cervical Cancer Treatment (PDQ®)–Health Professional Version

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Changes to This Summary (12/14/2018)

The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.

Treatment Option Overview for Cervical Cancer

Revised text to state palliative chemotherapy and other systemic therapy as standard treatment options for stage IVB and recurrent cervical cancer.

Stage IA Cervical Cancer Treatment

Added text about the Laparoscopic Approach to Cervical Cancer trial that provided evidence related to open abdominal surgery versus minimally invasive surgery (MIS) in patients with early-stage cervical cancer. Included eligibility criteria, the primary endpoint of noninferiority, disease-free survival (DFS) data, rates of recurrence, and overall survival (OS) rates between the two groups. Concluded that MIS is not noninferior to an open abdominal approach and should not replace open surgery as the standard for cervical cancer patients (cited Ramirez et al. as reference 3 and level of evidence 1iiA).

Added text about an epidemiologic study that utilized two large U.S. databases, the National Cancer Database (NCDB) and the Surveillance, Epidemiology, and End Results Database (SEER) database, and confirmed a reduction in OS in patients undergoing MIS radical hysterectomy for stage IA2 and stage IB1 cervical cancer from 2010 to 2013; also added that among women who underwent radical hysterectomy in the years 2000 to 2010, there was a decrease in OS after 2006, coincident with the widespread adoption of MIS for cervical cancer (cited Melamed et al. as reference 4 and level of evidence 3iA).

Added text to conclude that although questions remain regarding the use of MIS radical hysterectomy for some subpopulations of good-risk patients, the data from this trial suggest that open abdominal surgery should be considered the standard of care for patients with early-stage cervical cancer who are candidates for radical hysterectomy.

Stages IB and IIA Cervical Cancer Treatment

Added text about the Laparoscopic Approach to Cervical Cancer trial that provided evidence related to open abdominal surgery versus MIS in patients with early-stage cervical cancer. Included eligibility criteria, the primary endpoint of noninferiority, DFS data, rates of recurrence, and OS rates between the two groups. Concluded that MIS is not noninferior to an open abdominal approach and should not replace open surgery as the standard for cervical cancer patients (cited Ramirez et al. as reference 22 and level of evidence 1iiA).

Added text about an epidemiologic study that utilized two large U.S. databases, the NCDB and the SEER, and confirmed a reduction in OS in patients undergoing MIS radical hysterectomy for stage IA2 and stage IB1 cervical cancer from 2010 to 2013; also added that among women who underwent radical hysterectomy in the years 2000 to 2010, there was a decrease in OS after 2006, coincident with the widespread adoption of MIS for cervical cancer (cited Melamed et al. as reference 23 and levels of evidence 3iA and 3iiiA).

Stage IVB Cervical Cancer Treatment

Revised text to include palliative chemotherapy and other systemic therapy as standard treatment options for stage IVB cervical cancer.

Recurrent Cervical Cancer Treatment

Added text to state that with the exception of immunotherapy, which has provided prolonged DFS, other options are unlikely to result in curative outcomes and are mostly applied for palliative purposes.

Added text to include palliative chemotherapy and other systemic therapy as a treatment option for recurrent cervical cancer.

Added Immunotherapy as a new subsection.

This summary is written and maintained by the PDQ Adult Treatment Editorial Board, which is editorially independent of NCI. The summary reflects an independent review of the literature and does not represent a policy statement of NCI or NIH. More information about summary policies and the role of the PDQ Editorial Boards in maintaining the PDQ summaries can be found on the About This PDQ Summary and PDQ® - NCI's Comprehensive Cancer Database pages.

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