Int J Gynecol Cancer. 2018 May;28(4):641-655. doi: 10.1097/IGC.0000000000001216.
Despite significant advances in the screening, detection, and treatment of preinvasive cervical lesions, invasive cervical cancer is the fifth most common cancer in European women. There are large disparities in Europe and worldwide in the incidence, management, and mortality of cervical cancer.
The European Society of Gynaecological Oncology (ESGO), the European Society for Radiotherapy and Oncology (ESTRO), and the European Society of Pathology (ESP) jointly develop clinically relevant and evidence-based guidelines in order to improve the quality of care for women with cervical cancer across Europe and worldwide.
The ESGO/ESTRO/ESP nominated an international multidisciplinary development group consisting of practicing clinicians and researchers who have demonstrated leadership and expertise in the care and research of cervical cancer (23 experts across Europe). To ensure that the guidelines are evidence based, the current literature 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 development group. The guidelines are thus based on the best available evidence and expert agreement. Prior to publication, the guidelines were reviewed by 159 international reviewers, selected through ESGO/ESTRO/ESP and including patient representatives.
The guidelines cover comprehensively staging, management, and follow-up for patients with cervical cancer. Management includes fertility sparing treatment; stage T1a, T1b1/T2a1, clinically occult cervical cancer diagnosed after simple hysterectomy; early and locally advanced cervical cancer; primary distant metastatic disease; cervical cancer in pregnancy; and recurrent disease. Principles of radiotherapy and pathological evaluation are defined.
尽管在筛查、检测和治疗癌前宫颈病变方面取得了重大进展，但浸润性宫颈癌仍是欧洲女性中第五种最常见的癌症。在欧洲和全球范围内，宫颈癌的发病率、管理和死亡率存在巨大差异。
欧洲妇科肿瘤学会（ESGO）、欧洲放射肿瘤学会（ESTRO）和欧洲病理学会（ESP）联合制定了具有临床相关性和循证医学依据的指南，以改善欧洲和全球范围内宫颈癌患者的护理质量。
ESGO/ESTRO/ESP 提名了一个由实践临床医生和研究人员组成的国际多学科发展小组，这些人员在宫颈癌的护理和研究方面表现出领导力和专业知识（欧洲的 23 名专家）。为确保指南具有循证医学依据，对系统检索中确定的当前文献进行了审查和批判性评价。在缺乏明确科学证据的情况下，判断依据是发展小组的专业经验和共识。因此，这些指南基于现有最佳证据和专家共识。在发布之前，指南经过了 159 名国际评审员的审查，这些评审员是通过 ESGO/ESTRO/ESP 挑选的，包括患者代表。
指南全面涵盖了宫颈癌患者的分期、管理和随访。管理包括保留生育力治疗；T1a 期、T1b1/T2a1 期、单纯子宫切除术后诊断的临床隐匿性宫颈癌；早期和局部晚期宫颈癌；原发性远处转移性疾病；妊娠期宫颈癌；以及复发性疾病。还定义了放疗和病理评估的原则。
