Guideline for Gynecological Malignant
Tumors – Primary Complex Therapy in Operable
Stages of Malignant Tumors of Uterus Cervix
Rob L.1, Svoboda B.2, Robová H.1, Stankušová H.3, Cwiertka K.4, Neumannová R.5, Petera J.6, Koliba P.7, Kudela M.8
1Gynekologicko-porodnická klinika 2. LF UK a FN Motol, Praha, přednosta doc. MUDr. L. Rob, CSc. 2Gynekologicko-porodnická klinika 3. LF UK a FN KV, Praha, přednosta doc. MUDr. B. Svoboda, CSc. 3Radioterapeutické oddělení FN Motol, Praha, přednosta prim. MUDr. J. Prausová 4Onkologická klinika LF UP a FN, Olomouc, přednosta prof. MUDr. J. Macháček, CSc. 5Radioterapeutické odd. FN, Brno, prim. MUDr. R. Neumannová 6Onkologická klinika FN a LF UK, Hradec Králové, přednosta doc. MUDr. J. Petera, PhD. 7Gynekologicko-porodnická klinika FN, Ostrava, přednosta MUDr. P. Koliba, CSc. 8Gynekologicko-porodnická klinika LF UP a FN, Olomouc, přednosta prof. MUDr. M. Kudela, CSc. |
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Summary:
Objective: Elaboration of guideline for primary treatment of operable cervical cancer.
Design: Review, consensus between proposers and opponents.
Setting: Department of Obstetrics and Gynecology, Charles University, Prague, 2nd Medical Faculty
and Faculty Hospital Motol.
Method: A retrospective review of published data, analysis of Czech statistics and consensus
between proposers and opponents.
Results: Team work is essential in the diagnostic and therapeutic procedure. For the preoperative
diagnostic management it is possible to perform magnetic resonance volumometry. For the
treatment of early stage cervical cancer it is possible to perform sentinel lymph node mapping
(SLNM) by patent blau and 99mTc together with frozen section. SLNM does not substitute systematic
pelvic lymphadenectomy. For the treatment of IB2 stage cervical cancer, an alternative for
primary surgery or chemoradiotherapy is neoadjuvant chemotherapy, followed by radical surgery.
In other topics only minor changes were made from the 1998 guideline.
Conclusion: The guideline for cervical cancer treatment should represent directions for clinicians
and others, who participate in the process of the treatment of cervical cancer. The guidelines
include all parts of the process (from diagnosis to follow up). It originated from the consensus
between proposers and opponents: we voted about all parts of guideline.
Key words:
cervical cancer, guideline, diagnosis, treatment, follow up
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