University of Oklahoma Health Sciences Center

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Author/s:

Krishnansu S Tewari

Date Added:

January 8, 2025

Journal/Publication:

New England Journal of Medicine

Publication Date:

January 1, 2025

Issue:

Volume:

392

Pages:

56-71

URL:

Cervical Cancer

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1056/NEJMra2404457

PMID (1):

39752299

Keywords

cervical cancer

MeSH

uterine cervical neoplasms

RPR Commentary

A review of current knowledge regarding cervical cancer. James W. Mold, MD, MPH

Abstract

Cervical cancer is preventable through vaccination and treatment of dysplasia identified on screening (cytologic screening, DNA testing for high-risk human papillomavirus subtypes, or both).
Early-stage cervical cancer is treated with open radical hysterectomy and pelvic lymphadenectomy; small lesions can be treated with extrafascial hysterectomy or more conservative fertility-preserving operations.
Locally advanced cervical cancer is treated with chemoradiation therapy plus brachytherapy; incorporation of immunotherapy for International Federation of Gynecology and Obstetrics (FIGO) stage III through IVA disease is associated with a survival benefit.
Isolated, centrally recurrent cervical cancer may be managed by means of pelvic exenteration with urinary diversion; however, owing to an increased incidence of distant or concomitant pelvic and extrapelvic relapse after widespread adoption of chemoradiation for locally advanced disease, fewer patients are candidates for this operation than in previous years.
Patients with newly diagnosed recurrent or metastatic disease may benefit from chemotherapy plus immunotherapy, with or without bevacizumab.
Antibody–drug conjugates may be an option for patients with disease progression after treatment with chemotherapy plus immunotherapy.

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