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. 2023 May 1;33(5):649-666.
doi: 10.1136/ijgc-2023-004429.

ESGO/ESTRO/ESP Guidelines for the management of patients with cervical cancer - Update 2023

David Cibula  1   2 , Maria Rosaria Raspollini  3 , François Planchamp  4 , Carlos Centeno  5 , Cyrus Chargari  6 , Ana Felix  7   8 , Daniela Fischerová  9   2 , Daniela Jahnn-Kuch  10 , Florence Joly  11 , Christhardt Kohler  12   13 , Sigurd Lax  14   15 , Domenica Lorusso  16   17 , Umesh Mahantshetty  18 , Patrice Mathevet  19 , Raj Naik  20 , Remi A Nout  21   22 , Ana Oaknin  23   24 , Fedro Peccatori  25 , Jan Persson  26   27 , Denis Querleu  16   28 , Sandra Rubio Bernabé  29 , Maximilian P Schmid  30 , Artem Stepanyan  31 , Valentyn Svintsitskyi  32 , Karl Tamussino  33 , Ignacio Zapardiel  34 , Jacob Lindegaard  35
Affiliations

ESGO/ESTRO/ESP Guidelines for the management of patients with cervical cancer - Update 2023

David Cibula et al. Int J Gynecol Cancer. .

Abstract

In 2018, the European Society of Gynecological Oncology (ESGO) jointly with the European Society for Radiotherapy and Oncology (ESTRO) and the European Society of Pathology (ESP) published evidence-based guidelines for the management of patients with cervical cancer. Given the large body of new evidence addressing the management of cervical cancer, the three sister societies jointly decided to update these evidence-based guidelines. The update includes new topics to provide comprehensive guidelines on all relevant issues of diagnosis and treatment in cervical cancer.To serve on the expert panel (27 experts across Europe) ESGO/ESTRO/ESP nominated practicing clinicians who are involved in managing patients with cervical cancer and have demonstrated leadership through their expertise in clinical care and research, national and international engagement, profile, and dedication to the topics addressed. To ensure the statements were evidence based, new data identified from a systematic search was reviewed and critically appraised. In the absence of any clear scientific evidence, judgment was based on the professional experience and consensus of the international development group. Before publication, the guidelines were reviewed by 155 independent international practitioners in cancer care delivery and patient representatives.These updated guidelines are comprehensive and cover staging, management, follow-up, long-term survivorship, quality of life and palliative care. Management includes fertility sparing treatment, early and locally advanced cervical cancer, invasive cervical cancer diagnosed on a simple hysterectomy specimen, cervical cancer in pregnancy, rare tumors, recurrent and metastatic diseases. The management algorithms and the principles of radiotherapy and pathological evaluation are also defined.

Keywords: Cervical Cancer; Pathology; Radiation; Surgical Oncology.

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Conflict of interest statement

Competing interests: CCh has reported advisory boards for GSK, MSD and EISAI; SFL has reported advisory boards for MSD, GSK, AstraZeneca and Novartis; DL has reported consultant honoria from AstraZeneca, Clovis Oncology, GSK, MSD, Immunogen, Genmab, Amgen, Seagen and PharmaMar, advisory boards for AstraZeneca, Merck Serono, Seagen, Immunogen, Genmab, Oncoinvest, Corcept and Sutro, research institutional funding from Clovis Oncology, GSK, MSD and PharmaMar, research sponsored by AstraZeneca, Clovis Oncology, Genmab, GSK, Immunogen, Incyte, MSD, Roche, Seagen and Novartis, and speakers’ bureau activities for AstraZeneca, Clovis Oncology, GSK, MSD and PharmaMar; UM has reported advisory boards for AstraZeneca (Steering committee member for CALLA Study); RN has reported research grants from Elekta, Varian, Accuray, Dutch Research Council, and Dutch Cancer Society; AO has reported personal fees for advisory board membersip from Agenus, AstraZeneca, Clovis Oncology, Corcept Therapeutics, Deciphera Pharmaceuticals, Eisai, EMD Serono, F. Hoffmann-La Roche, Genmab/Seagen, GSK, ImmunoGen, Itheos, Merck Sharp & Dohme de Espana, SA, Mersana Thereapeutics, Novocure, PharmaMar, piIME Oncology, Roche, Sattucklabs, Sutro Biopharma and Tesaro, and personal fees for travel/accomodation from AstraZeneca, PharmaMar and Roche; DQ has reported advisory boards for Mimark inc; MPS has reported research grants and personal fees for workshops from Elekta AB; DC, MRR, FP, CC, AF, DF, DJK, FJ, CK, PM, RN, FPec, JP, SR, AS, VS, KT, IZ and JCL have reported no conflicts of interest.

Figures

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Figure 1
Guideline development process.
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Figure 2
Levels of evidence and grades of recommendations.
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Conization.
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Simple trachelectomy.
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Radical (vaginal) trachelectomy.
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Abdominal radical trachelectomy.
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Figure 7
Ovarian transposition.
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References

    1. Arbyn M, Weiderpass E, Bruni L, et al. . Estimates of incidence and mortality of cervical cancer in 2018: a worldwide analysis. Lancet Glob Health 2020;8:e191–203. 10.1016/S2214-109X(19)30482-6 - DOI - PMC - PubMed
    1. Dyba T, Randi G, Bray F, et al. . The european cancer burden in 2020: incidence and mortality estimates for 40 countries and 25 major cancers. Eur J Cancer 2021;157:308–47. 10.1016/j.ejca.2021.07.039 - DOI - PMC - PubMed
    1. Das M. WHO launches strategy to accelerate elimination of cervical cancer. Lancet Oncol 2021;22:20–1. 10.1016/S1470-2045(20)30729-4 - DOI - PubMed
    1. Cibula D, Pötter R, Planchamp F, et al. . The European Society of Gynaecological Oncology/European Society for Radiotherapy and Oncology/European Society of Pathology Guidelines for the management of patients with cervical cancer. Int J Gynecol Cancer 2018;28:641–55. 10.1097/IGC.0000000000001216 - DOI - PubMed
    1. Cibula D, Pötter R, Planchamp F, et al. . The European Society of Gynaecological Oncology/European Society for Radiotherapy and Oncology/European Society of Pathology Guidelines for the management of patients with cervical cancer. Radiother Oncol 2018;127:404–16. 10.1016/j.radonc.2018.03.003 - DOI - PubMed

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