Early Cervical Cancer: Current Dilemmas of Staging and Surgery

Abstract

Purpose of review: Advances in cervical cancer screening and treatment have resulted in high cure rates in developed countries for early-stage disease. Current research focuses on minimizing morbidity and maximizing quality of life.

Recent findings: Imaging has been disappointing in identifying small volume metastases. Sentinel lymph node biopsy represents a significant advantage with high sensitivity, low false negative rates, reduced morbidity, and equivalent survival in recent studies compared to pelvic lymphadenectomy. Non-radical surgical options are currently being investigated for early cervical cancer in a number of large prospective studies in patients at low risk for metastases. Evidence suggests that sentinel lymph node biopsy and non-radical surgery are safe approaches for the staging and management of early cervical cancer in appropriately selected patients with the potential to significantly reduce treatment-related morbidity.

Keywords: Cervical cancer staging; Early cervical cancer; Fertility-sparing surgery; Pelvic lymphadenectomy; Sentinel lymph nodes; Uterine cervical neoplasm.