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.
*Gynecologic Oncology Center, Department of Obstetrics and Gynecology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic; †Department of Radiotherapy, Medical University of Vienna, Vienna, Austria; ‡Institut Bergonié, Bordeaux, France; §Linkoping University, Linkoping, Sweden; ∥Department of Radiotherapy, Institut Gustave Roussy, Villejuif, France; ¶Asklepios Hambourg Altona and University of Cologne, Medical Faculty, Department of Gynecology, Germany; #University of Milan Bicocca, Monza, Italy; **General Hospital Graz Sued-West, Graz, Austria; ††Department of Oncology, Aarhus University, Aarhus, Denmark; ‡‡Department of Radiation Oncology, Tata Memorial Hospital, Mumbai, India; §§Lausanne University, Lausanne, Switzerland; ∥∥Department of Pathology, Belfast Health and Social Care Trust, Belfast, United Kingdom; ¶¶University College Hospital London, London, United Kingdom; ##Queen Elizabeth Hospital, Gateshead, United Kingdom; ***Department of Radiation Oncology, Leiden University, Leiden, the Netherlands; †††Istituto Nazionale per lo Studio e la Cura dei Tumori “FondazioneG Pascale,” IRCCS, Naples, Italy; ‡‡‡University Hospital of Bellvitge (IDIBELL), Barcelona, Spain; §§§Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy; ∥∥∥Athens University, Athens, Greece; ¶¶¶Medical University of Graz, Graz, Austria; ###Dresden University, TU Dresden, Dresden, Germany; ****University Hospital, Careggi, Florence, Italy.
Address correspondence and reprint requests to David Cibula, MD, Department of Obstetrics and Gynecology, Kateřinská 32, 121 08 Prague, Czech Republic. E-mail: firstname.lastname@example.org.
The authors declare no conflicts of interest.
Initiated through the European Society of Gynaecological Oncology (ESGO), the decision to develop multidisciplinary guidelines has been made jointly by ESGO, the European Society for Radiotherapy and Oncology (ESTRO), and the European Society of Pathology (ESP). ESGO has provided administrative support. The only external funding source was a grant from the Institut National du Cancer (France). ESGO, ESTRO, and ESP are nonprofit knowledgeable societies. The Institut National du Cancer is a French government agency.
The development group (including all authors) is collectively responsible for the decision to submit for publication. D.C. (chair), R.P. (cochair), M.R.R. (cochair), and F.P. (methodologist) have written the first draft of the manuscript. All other contributors have actively participated to the development group, given personal input, reviewed the manuscript, and given final approval before submission.
These guidelines statements were developed by ESGO, ESTRO and ESP and are published in the International Journal of Gynecological Cancer, Radiotherapy & Oncology and Virchows Archiv
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Received January 12, 2018
Accepted January 12, 2018