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cervical cancer algorithm - Coggle Diagram
cervical cancer algorithm
History and physical exam, CBC, CONE biopsy, LFTs, renal function studies, imaging, smoking cessation, counseling intervention, HIV testing, consider examination under anesthesia, cystoscopy or proctoscopy, fertility testing, and assess for distress
squamous cell cancer or adenocarcinoma or adenosquamous carcinoma
Stage I
AI
Primary treatment(FERTILITY SPARING)
LVSI negative with surveillence
Primary treatment(non-fertility sparing)
LVSI positive Hysterectomy type A
B3
A2/B1
Primary treatment (fertility sparing)
Primary treatment(non-fertility sparing)
small tumors < or equal to 2 cm
Hysterectomy+lymph node removal
B2
Primary treatment(non-fertility sparing)
Radical trachelectomy+ SLN mapping or pelvic lymphedectomy+/- para-aortic lymphadectomy( done to stage B1 if patient doenst meet surgery criteria
stage 2
A2
Primary treatment
PELVIC EBRTN + PLATINUmM containig therapy+ brachtherapy or hystrectomy+pelvic lymphadenectomy+/- para aortic lymphadectomy or pelvic EBRT+ PLATINUM chemotherapy+ brachtherapy+ completion hystrectomy
B
Primary treatment
if negative distant metastssi and negative after biopsy for positive distant metastssis: EBRT+platinum chemotherapy+brachtherapy+/- Pembrolizumab(if nega
if positive: sysytemic therapy+individualized radiotherapy( if patient has positive distant metastasis)
A1
Rdical hyrestectomy+ SLN mapping or pelvic lympjhadenopathy+/- para-aortic lymphadenopathy or pelvic EBRT + brachytherapy+/- para-aortic lymphadenopathy
A1
Stage 3
Stage 4
A
B
Treatment
Amenaable local treatemnt
Resection+/- EBRT or local ablative therapy+/-individua;ized EBRT OR INDIVIDUA;IZED ebrt+/- PLATINUM contaning therapy
non-amenable local treatment
Systemic therapy and supportive care
Incidental finding of invasive cancer after simple hysterectomy
Treatment