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Cervical Cancer Tx
Gynae Oncology
Question | Answer |
---|---|
Treat CIN1 (LSIL) | Observe with pap smear every 6 mos |
treat recurrent cin 1 (2 times) | colposcopy |
treat progressive cin 1 (lsil) | Excise: LLETZ/cone Ablate: Laser/cryocautery |
cin 2 and cin 3 | Excise (LLETZ, cone) and hysterectomy if no future child bearing |
stage 1a1 | 1. wertheim's operation OR 2. primary radiotherapy OR radical trachelectomy for fertility. Adjuvant chemoradiation if positive LN, parametria or margins |
stage 1b2 and up | primary chemoradiation. no hysterectomy |
Wertheim's operation | uterus, cervix, upper 1/3rd of vagina, parametrium, extensive LN |
LN removed in Wertheim's | paracervical, presacral, superior vesical, obturator, int iliac, external iliac, common iliac |