Muallem Mustafa Zelal, Sayasneh Ahmad
Department of Gynecology with Center for Oncological Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Virchow Campus Clinic, Charité Medical University, 13353 Berlin, Germany.
Department of Gynecological Oncology, Guy's and St Thomas' NHS Foundation Trust, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Road, London SE1 7EH, UK.
Diagnostics (Basel). 2025 May 6;15(9):1174. doi: 10.3390/diagnostics15091174.
Cervical cancer remains a significant health challenge globally, with locally advanced cervical cancer (LACC) representing a particularly complex subset due to its diverse definitions and varied treatment approaches. The absence of randomized controlled trials comparing the upfront radical surgery followed by concurrent chemoradiotherapy (CCRT) or chemotherapy alone for clearly defined risk factors for LACC hinders the development of standardized treatment protocols, leading to disparities in patient outcomes across different healthcare settings. This paper seeks to underline the necessity of a consensus on the definition of LACC and aims to comprehensively and critically review the existing literature trying to harmonize treatment strategies and improve prognostic outcomes. Our analysis suggests a multimodal approach for treating FIGO IB3, IIA2, and selected IIB cases at facilities capable of delivering highly curative nerve-sparing surgical interventions, with the goal of bridging the gap in current treatment methodologies. Preliminary findings suggest that adopting a standardized definition could facilitate more consistent treatment outcomes and enhance comparative research.
宫颈癌仍然是全球一项重大的健康挑战，局部晚期宫颈癌（LACC）由于其定义多样和治疗方法各异，是一个特别复杂的亚组。由于缺乏针对LACC明确定义的危险因素，比较 upfront 根治性手术联合同步放化疗（CCRT）或单纯化疗的随机对照试验，阻碍了标准化治疗方案的制定，导致不同医疗环境下患者的治疗结果存在差异。本文旨在强调对LACC定义达成共识的必要性，并旨在全面、批判性地回顾现有文献，以协调治疗策略并改善预后。我们的分析表明，对于能够提供高治愈率的保留神经手术干预的机构，应采用多模式方法治疗FIGO IB3、IIA2和部分IIB病例，目标是弥合当前治疗方法的差距。初步研究结果表明，采用标准化定义有助于获得更一致的治疗结果并加强比较研究。
