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Cervical large cell neuroendocrine carcinoma (LCNEC) is a special type of cervical cancer with characteristics of high malignancy and aggressiveness, and shows a tendency to metastasize systemically at an early stage. The development of cervical LCNEC is closely related to high-risk HPV infection. The diagnosis of cervical LCNEC is mainly based on typical pathological features and detection of specific neuroendocrine markers because of the lack of specificity of clinical manifestations. Due to the low incidence of cervical LCNEC and limited case data, there is no standardized treatment protocol, and its treatment is mainly based on small cell lung cancer, with radical surgery combined with chemotherapy and radiotherapy. However, genomic data suggest that cervical LCNEC is genetically more similar to common types of cervical cancer rather than to small cell neuroendocrine carcinoma outside the cervix, such as lung or bladder, which questions the ideas of adopting similar treatment regimens because of similar morphological manifestations among tumor tissues. This article focuses on a review of recent research advances regarding cervical LCNEC, with the aim of providing references and lessons for clinical work. [ABSTRACT FROM AUTHOR]

Cervical mucinous adenocarcinoma is a rare and special histological type of cervical malignant tumor, which mainly includes adenocarcinoma of the cervix gastric type, adenocarcinoma of the cervix and intestines, and primary cervical signet-ring cell carcinoma. Due to the uncertainty between the pathogenesis of cervical mucinous adenocarcinoma and human papillomavirus (HPV) infection makes it difficult to be suggested by routine cervical cancer screening. Meanwhile, the etiology and pathogenesis of cervical mucinous adenocarcinoma are not clear, and there is a lack of typical clinical manifestations and early diagnosis methods, and the clinicopathological features and treatment are different from those of cervical common adenocarcinoma, resulting in patients being prone to miss the best treatment time, so the prognosis of cervical mucinous adenocarcinoma is worse than that of cervical common adenocarcinoma. In recent years, due to the popularization of HPV vaccine, the relative incidence of cervical mucinous adenocarcinoma has slightly increased compared with before, and the research on cervical mucinous adenocarcinoma has received more and more attention. The relevant research on cervical mucinous adenocarcinoma at home and abroad is reviewed, and the relevant pathogenesis, clinical features and treatment of cervical mucinous adenocarcinoma are discussed, in order to provide a reference for the clinical diagnosis and treatment of cervical mucinous adenocarcinoma. [ABSTRACT FROM AUTHOR]

Cervical cancer is the most common malignant tumor of the reproductive system among women in China. Its incidence is gradually becoming younger, posing a serious threat to women′s life and health. Several studies have shown that energy metabolism is reprogramming in cervical cancer cells, which glycolysis is used to provide biological energy even if oxygen is sufficient. This change is closely related to multiple glycolytic enzymes, transporter proteins, regulatory molecules and specific signaling pathways. Alteration of glucose metabolism promotes malignant processes such as growth, proliferation, migration and invasion through different mechanisms in cervical cancer cells, and affects the sensitivity of the patients to radiotherapy and chemotherapy. Analysis of the expression of proteins related to this metabolic process can predict the prognosis of cervical cancer, and blocking its expression may have anti-cancer effects. Therefore, glycolytic metabolism-related proteins are expected to be potential targets for cervical cancer treatment. This paper reviews the pathological mechanism that glucose metabolism involves in the development and progression of cervical cancer, so as to explore novel therapeutic strategies for energy metabolism, and also provides basis for improving therapeutic prospect and prolonging the survival of the patients. [ABSTRACT FROM AUTHOR]

Glassy cell cervical carcinoma (GCCC) is a very rare form of cervical carcinoma, which belongs to the low-differentiated subtype of adenosquamous carcinoma, and the related reports at home and abroad are few. Due to its rarity and particularity, there are currently no relevant guidelines for diagnosis and treatment of this disease. This article reports the diagnosis and treatment process of a 43-year-old patient with stage ⅡB GCCC who underwent laparoscopic total hysterectomy combined with bilateral adnexectomy after concurrent chemoradiotherapy, and was also given 3 courses of adjuvant chemotherapy with paclitaxel and cisplatin. However, in a short period of time, there have been multiple metastases throughout the body. The patient responded poorly to multiple chemotherapy regimens and was eventually lost. This article reviews the relevant literature both domestic and abroad, aiming to improve the understanding, diagnosis and treatment of the disease, and provide more reference for diagnosis and treatment for follow-up study of this disease. [ABSTRACT FROM AUTHOR]

Objective: To investigate the clinical characteristics, treatment and prognosis of primary cervical malignant melanoma. Methods: The clinical data and follow-up data of 13 patients with primary cervical malignant melanoma diagnosed by pathology in Affiliated Cancer Hospital of Zhengzhou University were collected from January 2013 to December 2019. Analysis the clinical characteristics, treatment and prognosis. Results: The 13 patients were 30-64 years old, with an average age of (51.1±10.8) years old. According to FIGO 2018 staging system, there were 4 stage Ⅰ patients, 3 stage Ⅱ patients, 1 stage Ⅲ patient, and 5 stage Ⅳ patients. Six patients with stage ⅠA-ⅡA were treated with surgery, of which 2 patients received observation only, 3 patients received chemotherapy after surgery, and one patient received chemotherapy+immunotherapy. Two patients with stage ⅡB to Ⅲ and two patients with stage Ⅳ received radiotherapy + chemotherapy. The remaining 3 patients with stage Ⅳ received a combination of chemotherapy, local radiotherapy, immunotherapy or targeted therapy. The median follow-up time was 12 months (7-84 months), 9 patients died, distant metastasis occurred in 3 cases, and the median overall survival was 38 months. Conclusions: Primary cervical malignant melanoma is a relatively rare but highly malignant tumor with poor prognosis and susceptibility to distant metastasis. Surgical resection is the main treatment modality for early-stage patients, and a combination of immunotherapy and targeted therapy may be a new option for metastatic and unresectable patients. [ABSTRACT FROM AUTHOR]

Ovarian cancer, endometrial cancer and cervical cancer are three major malignancies in gynecology. The prognosis of patients with gynecologic tumors has been improved significantly with the development of comprehensive treatments such as surgery, radiotherapy and chemotherapy, however, due to the lack of obvious symptoms and accurate diagnosis at early stages, there are still a considerable proportion of patients with poor prognosis life-threatening. Therefore, it is very important to identify new therapeutic targets and predictive markers for prognosis. Metabolomics is a popular research method in the field of cancer research. Its theoretical basis is that tumors have different metabolic characteristics from normal tissues, which are closely related to biological phenotypes. Through comprehensive analysis of endogenous metabolites in biological systems, metabolomics elucidates the remodeling mechanism of some key biochemical pathways during tumor development and progression, and provides analytical and precise intervention. This paper reviews the application of metabonomics in the treatment and prognosis of gynecological tumors, which is expected to provide potential targets for personalized and precise treatment of gynecological tumors, and provide important reference for selecting biomarkers for prognosis of gynecological tumors. [ABSTRACT FROM AUTHOR]

Cervical cancer is the most common gynecological malignant tumor, which is a serious threat to women's health. High-risk human papillomavirus (HPV) persistent infection is the main risk factor of the cervical cancer. In recent years, HPV vaccine has achieved favorable results in the prevention of cervical cancer. Immunotherapy has also become a new pattern of treatment of cervical cancer, especially for patients with poor effect of surgery, radiotherapy and chemotherapy, postoperative metastasis and late recurrence. The strategies of immunotherapy mainly include immune checkpoint inhibitors, vaccine therapy, dendritic cell immunotherapy and adoptive cellular immunotherapy. At present, the related immunotherapy has achieved good results in the treatment of cervical cancer and its precancerous lesions. This article will describe the progress of immunotherapy in cervical cancer, and look forward to the future research direction, so as to provide a basis for clinical treatment and fundamental research of cervical cancer. [ABSTRACT FROM AUTHOR]

Cervical cancer is one of the most common female reproductive system tumors in China, which seriously threatens women's life and health. HOTAIR is a typical antisense long non-coding RNA, and its expression in cervical cancer cells is significantly increased, which is closely related to the occurrence and development of cervical cancer. In recent years, researches on the mechanism of HOTAIR in the occurrence and development of cervical cancer found that HOTAIR inhibits the expression of a large number of tumor suppressor genes, and is widely involved in the proliferation, apoptosis, invasion and migration of cervical cancer cells. HOTAIR assists the treatment of advanced cervical cancer by regulating the resistance to radiotherapy, anti -retroviral transcription and immune targeting. It plays an important role in the genetic susceptibility of cervical cancer, and has a significant correlation with tumor progression and poor prognosis. In the future, therapeutic targets will be designed according to the molecular mechanism of HOTAIR, and their effectiveness and practicability would be confirmed through large-sample, multi-center, prospective clinical trials, which will provide new ideas for the early diagnosis and personalized treatment of cervical cancer patients. [ABSTRACT FROM AUTHOR]

Objective：The clinical data of small cell neuroendocrine carcinoma of the cervix were analyzed retrospectively in order to provide the basis for the diagnosis and treatment of this disease. Methods：The clinical data of 59 patients with small cell neuroendocrine carcinoma of the cervix were collected in Guangxi Medical University Affiliated Tumor Hospital, and the prognosis of the patients was followed up. The age of onset, clinical manifestations, human papillomavirus (HPV) typing, pathological diagnosis, postoperative pathology in different clinical stages, treatment plan and survival were statistically analyzed. Results：The median age of onset of the 59 patients was 43.6 years. The main clinical manifestation is irregular vaginal bleeding (53 cases, 89.8%). The positive rate of HPV18 in HPV typing was the highest (48 cases, 81.4%). Immunohistochemical tests showed that 58 cases (98.3%) were positive for Syn, 49 cases (83.1%) were positive for CgA, 58 cases (98.3%) were positive for NSE, and 50 cases (84.7%) were positive for CD56. Thirty-nine patients with clinical stage ⅠB and ⅡA underwent surgical treatment, including 23 patients (59.0%) with deep muscular infiltration, 11 patients (28.2%) with lymph vascular space infiltration (LVSI), and 9 patients (23.1%) with pelvic lymph node metastasis. The cut-off date for followup was July 31, 2019. All patients were followed for more than 5 years. Of the 59 patients, 19 survived and 40 died. The mean survival time was 22.6 months, and the median survival time was 20.2 months. Kaplan-Meier Log-Rank test was used for survival analysis. Clinical stage (Log-Rank P=0.000), lymph node metastasis (Log-Rank P=0.015), and depth of tumor invasion (Log-Rank P=0.009) were the prognostic factors. LVSI (Log-Rank P=0.450), neoadjuvant chemotherapy (Log-Rank P=0.856), postoperative adjuvant radiotherapy (Log-Rank P=0.900), TP/TC (paclitaxel or docetaxel + platinum) regimen or EP (etoposide+cisplatin) regimen (Log-Rank P=0.939) had no significant effect on prognosis. Conclusions：The main clinical manifestation of this disease is irregular vaginal bleeding. The disease is closely related to HPV18 infection. Infiltration and metastasis occurred in early cases. Diagnosis of the disease requires immunohistochemistry. The later the clinical stage, with lymph node metastasis and deep tumor infiltration, the worse the prognosis. Early diagnosis and treatment are the key to improve the curative effect. [ABSTRACT FROM AUTHOR]

Circular RNAs (circRNAs) are single-stranded, covalently closed noncoding RNAs without 3′ and 5′ ends. Evidence demonstrated that circRNAs are abundant, stable and able to show cell/tissue-specific expression, which structure features show potential for noninvasive molecular biomarkers of tumors. CircRNAs express differentially and play an important role in many kinds of neoplasms by miRNA sponges, interaction with RNA binding proteins, modulating the stability of mRNAs, regulating gene transcription and translation proteins. There are no specific biomarkers for early warning and potential therapeutic targets currently. Many studies have demonstrated differential expression of circRNAs function vitally on singnal pathway and gene expression in the initiation and development of cervical cancer. CircRNAs involve in circRNA-miRNA-target gene axis mainly through miRNA sponges to promote cervical cancer cell proliferation, invasion and metastasis, and associate with tumor size, clinical stage, metastatic lymph nodes and poor prognosis. [ABSTRACT FROM AUTHOR]

Cervical cancer is the most common malignant tumor in gynecology. The report "global cancer statistics 2018" shows that cervical cancer ranks fourth in morbidity and mortality in female tumors worldwide. The research on cervical cancer has always been the focus of gynecological scholars. In recent years, with the development of microbiome, the composition and changes of vaginal microbiota and the invasion of human papillomavirus (HPV), persistent infection and cervical cancer are gradually increasing. Lactobacillus dominates the normal cervicovaginal flora. It can maintain the balance of vaginal microecology, inhibit the growth of pathogenic microorganisms, and enhance the local anti-infection and anti-tumor ability of the vagina. It is expected to become a new strategy for the treatment of cervical cancer in the future. Current studies have shown that abnormal changes of vaginal microflora are associated with the occurrence and development of cervical cancer, and some vaginal bacteria play a role directly or indirectly through different mechanisms. This paper reviews the anti-cancer mechanism of vaginal microflora and its potential application in cervical cancer. [ABSTRACT FROM AUTHOR]

Cervical cancer is one of the common gynecological malignancies. The etiology of the disease has been clear, mainly the persistent infection of human papillomavirus (HPV). In recent years, with the advent of preventive vaccines and the popularization of screening work, early diagnosis and treatment of cervical cancer have achieved some results. However, its incidence and mortality are still high, which seriously threatens the life and health of women. Actively exploring the early diagnosis and treatment of cervical cancer can further improve the prognosis of patients with cervical cancer. Long non-coding RNA (lncRNA) is a kind of RNA without protein coding function, which participates in many biological processes. lncRNA is abnormally expressed in a variety of malignant tumors and plays a role in carcinogenesis or cancer inhibition. More and more studies have found that lncRNA is closely related to cervical cancer and plays an important role in the occurrence, invasion, metastasis and drug resistance of cervical cancer. To explore the role of lncRNA such as metastasis-associated lung adenocarcinoma transcript 1 (MALAT1), HOX antisense intergenic RNA (HOTAIR), antisense non-coding RNA in the INK4 locus (ANRIL), EBIC, CCHE1 in the development of cervical cancer, and to summarize their molecular mechanisms in cervical cancer, so as to provide new ideas for the early diagnosis and targeted therapy of cervical cancer. [ABSTRACT FROM AUTHOR]

Cervical carcinoma is one of the most common cancers of women, which has a higher incidence in developing countries. With the popularization of the screening in cervical carcinoma, the incidence of cervical carcinoma, especially squamous cell carcinoma has declined. However, because human papilloma virus (HPV) infection does not always accompany cervical adenocarcinoma and the lesion is deep into the cervical canal, the existing screening methods are less effective in the diagnosis of cervical adenocarcinoma. Compared with cervical squamous cell carcinoma, the prognosis of cervical adenocarcinoma is poor. Gene methylation is an important part of epigenetic modification, which can change gene structure and inhibit gene expression without changing DNA sequence. The methylation of tumor suppressor gene can make it inactivated and lose its inhibitory effect on tumor, which is closely related to the occurrence and development of tumor. In this paper, the research progress of gene methylation in cervical adenocarcinoma was reviewed in order to provide new ideas for early diagnosis and treatment of cervical adenocarcinoma. [ABSTRACT FROM AUTHOR]

Cervical cancer, endometrial cancer and ovarian cancer are three common malignant tumors in gynecology. At present, the age of onset tends to be younger. Although gynecological malignancies are not common in pregnancy, epidemiological studies have been confirmed that the incidence rate of these diseases has been increasing in recent years. Cervical and ovarian cancers are the most common gynecological cancers in pregnancy, and endometrial cancer is rare in pregnancy. Due to the complexity of clinical management of gynecological malignancies during pregnancy, its treatment methods have been paid more attention. It is necessary to comprehensively consider the tumor stage, differentiation degree, histological type, gestational week, wishes of patients and possible fetal outcomes, comprehensively evaluate the condition of the disease and formulate individualized treatment plan. Conservative treatment, surgical treatment or chemotherapy can reduce the influence of malignant tumor on fetus and maintain pregnancy and maternal reproductive function on the basis of maternal health. In this paper, different treatment methods of gynecological malignant tumor in pregnancy were summarized in order to achieve better maternal and infant outcomes and provide reference for clinical experience. [ABSTRACT FROM AUTHOR]

Cervical cancer is one of the most common malignant tumors in gynecology. The main treatment methods for early cervical cancer include abdominal surgery and minimally invasive surgery. Abdominal radical hysterectomy, a traditional surgical procedure for early-stage cervical cancer, has disadvantages of large surgical trauma, large amount of bleeding, and slow recovery of postoperative organ functions. Minimally invasive surgery is praised by most gynecologists for its advantages of less trauma, less blood loss, and rapid recovery. Although it is suggested that laparoscopy ensures the endpoints of safety, feasibility and efficacy, no mature data on oncologic results exists. A prospective study and a large retrospective study of earlystage cervical cancer, which published in the New England Journal of Medicine in 2018, have shown that laparoscopic applications led to an increased recurrence rates and a decline in long-term prognosis, leading to international controversy. It is important to analyze the factors that may affect the prognosis of minimally invasive surgery for cervical cancer, providing the most effective and advanced surgical treatment for cervical cancer patients. [ABSTRACT FROM AUTHOR]

Due to the application of cervical cytology and HPV combined screening technology, the detection rate of early cervical cancer has been increased, and the surgical effect of early low-risk cervical cancer is satisfactory. The criteria of low-risk cervical cancer included: the maximum diameter of cervical tumor was not more than 2 cm; the depth of infiltrating interstitial was not more than 10 mm; no lymph vascular space invasion. Low-risk cervical cancer with parametrial involvement, lymph node metastasis and margin-positive probability is low, the overall prognosis is better. Therefore, it is suggested that conservative surgery can be used for low-risk cervical cancer patients. The nerve-sparing radical resection of cervical cancer does not affect the defecation and urination function of the patients and improves the quality of life of the patients after operation. The sensitivity of preoperative magnetic resonance imaging in predicting postoperative parametrial involvement is high. Patients with early low-risk cervical cancer found after hysterectomy can avoid radical hysterectomy, and the incidence of residual diseases and the probability of adjuvant treatment are very low. The fertility -sparing procedures include simple trachelectomy, cervical conization, and radical trachelectomy, with a same recurrence rate comparable to radical hysterectomy and favorable pregnancy outcomes. For minimally invasive cervical adenocarcinoma, the surgical treatment procedure should be the same as for squamous cell carcinoma. [ABSTRACT FROM AUTHOR]

Cervical cancer is the second largest female malignant tumor after breast cancer. The main pathogenic factor of cervical cancer is human papillomavirus (HPV) infection. The incidence and mortality of cervical cancer have been decreased thanks to the use of HPV vaccine and advances in surgery and chemoradiotherapy. However, metastasis, recurrence and drug resistance are still great challenges in clinical therapeutics. Long-stranded non-coding RNA (lncRNA) is longer than 200 nt, most of which can not encode proteins, and only a few of which are translated into peptides. LncRNAs such as H19 and HOTAIR have been proved to play an important role in the initiation and progression of cervical cancer, and are closely related to the abnormal activation of PI3K/Akt, Wnt and other signaling pathways. LncRNA involved in the development of cervical cancer and its signal pathways are reviewed to explore potential biomarkers for diagnosis or prediction of prognosis, or effective targets for gene therapy. [ABSTRACT FROM AUTHOR]

Pregnancy with cervical cancer is relatively rare, early clinical manifestations are not typical. Due to the lack of awareness of gynecological tumor screening, it is easy to be confused with premature rupture of membranes, threatened premature delivery and other diseases, lead to treatment delay. There is no mature and standardized treatment for cervical cancer in pregnancy, especially the treatment of cervical cancer in the mid trimester of pregnancy is controversial. It is necessary to formulate individualized comprehensive treatment plan according to disease examination, staging, fetal development and pregnant women′s pregnancy expectation. This is a retrospective analysis of a case of second trimester pregnancy with cervical cancer who was admitted to the hospital with vaginal bleeding, after failure of conservative treatment, cesarean section was performed to terminate the pregnancy. We report this case and review the relevant literature, hoping to provide experience for the diagnosis and treatment of the disease. [ABSTRACT FROM AUTHOR]

As the age of pregnancy grows, the rate of cervical cancer during pregnancy is increasing and the management of cervical cancer during pregnancy is also becoming more difficult in clinic. During treatment, safety of both pregnant women and offspring should be taken into account. Management of patients wishing to preserve of her pregnancy aim at fewer adverse effects on fetuses, less tumor progress and similar outcomes with non-pregnancy women with cervical cancer. Current options to treat pregnant patients with cervical cancer desired to preserve pregnancy contains expectant treatment, surgery and chemotherapy. Radical trachelectomy, simple trachelectomy and conization are common surgical methods and most common chemotherapy is based on platinum，with or without other agents. Commonly, patients with stage ⅠA1 cervical cancer are eligible for expectant treatment. Surgical treatment is option for patients with stage ⅠA2-ⅠB1 cervical cancer and neoadjuvant chemotherapy is used in patients with stage ⅠB1 or greater cervical cancer. Patients with lymph nodes metastasis should terminate pregnancy. We will make conclusions on the latest progression of pregnancy-preserving managements. [ABSTRACT FROM AUTHOR]

Objective:To discuss the clinical and pathological characteristics, therapy and prognosis of clear cell adenocarcinoma of cervical (CCAC). Methods: We performed a retrospective review of 13 patients with CCAC who were diagnosed and treated at the First Affiliated Hospital of Zhengzhou University from April 2013 to December 2017. Result: The age of the patients was (53.6±13.9) years,of which 9 (69.2%) were older than 40 years and 4 (30.8%) were younger than 40 years, 2 were adolescents. The International Federation of Gynecology and Obstetrics stage: 46.15% (n=6) stage I, 46.15% (n=6) stage II, 7.7% (n=1) stage III. Twelve patients underwent surgery followed by radiotherapy and chemotherapy, including 3 patients treated by neoadjuvant chemotherapy, 9 postoperative adjuvant radiotherapy and/or chemotherapy. One patient was treated by radiotherapy alone. The median follow-up time was 24 months (6-60 months). 4 patients died and 2 patients had multiple metastases. The 1-year, 2-year and 5-year survival rates were 12/13,11/13 and 9/13, respectively. Conclusions: CCAC has low incidence, nonspecific clinical manifestations and poor prognosis with lymph node metastasis. The individualized comprehensive treatment of surgery followed by radiotherapy and chemotherapy can significantly improve the patient' s condition. [ABSTRACT FROM AUTHOR]

Invasive cervical cancer in women younger than 35-year-old is generally called young cervical cancer, and its incidence has been increasing in recent years. Cervical cancer in young women progresses more rapidly than in older patients, which might be related with young women′ s high level of estrogen and their susceptibility to disordered vaginal microenvironment. The proportion of non-squamous cell carcinoma in young patients is higher than in older ones, leading to difficulty in diagnosis. However, taking imaging diagnosis and new molecular markers as novel auxiliary diagnosing methods have improved the efficiency of diagnosis. Young patients require fertility and better life quality, therefore, on the basis of traditional surgery, some new therapies, like minimally invasive surgery and uterine transplantation and so on, have been born. Advanced cervical cancer patients mainly conduct radiation/chemical therapy, some new types of radiation therapies (such as three-dimensional conformal radiation therapy and intensity modulated radiation therapy) can significantly improve young patients′ prognosis by killing more cancer cells and less normal tissue. [ABSTRACT FROM AUTHOR]

Cervical intraepithelial neoplasia (CIN) is recognized as a kind of precursor lesion associated with cervical cancer. With the great progresses of cervical cancer biology research and screening techniques, early detection and treatment of high grade CIN has become the goal of prevention of cervical cancer. The major ethical and medical aim of all management options for CIN is the prevention of cervical cancer. To date, the "three-step" technique is still the primary way to detect and diagnose of CIN. For management of CIN, observational management was recommended for women with CIN Ⅰ, whereas treatment of CINⅡ and CINⅢ should be excisional. Both loop electrosurgical excision procedure (LEEP) and laser conisation are accepted standard treatments for these patients. After treatment, cytology and human papillomavirus (HPV) testing are the best post-treatment monitoring for patients with low risk of tumor residue and recurrence, whereas colposcopy is recommended for patients with high risk of tumor residue and recurrence. The aim of this paper is to review the progresses of diagnosis,outcome, management and follow-up plan of CIN. [ABSTRACT FROM AUTHOR]

The morbidity of cervical cancer, endometrial cancer and ovarian cancer are increasing each year, and show younger trend. Many patients become iatrogenic menopause because of treating gynecologic cancer, show serious climacteric symptoms rapidly, and lead to lower quality of life. Menopausal hormone therapy (MHT)can control menopausal symptoms, relieve urogenital atrophy and prevent osteoporosis effectively. Studies indicate that it is relative safety for cervical squamous carcinoma, endometrial carcinoma of stage I and ovarian epithelial carcinoma to receive MHT; cervical adenocarcinoma, endometrial carcinoma of stage II and more than stage III, granulose cell tumor of ovary and endometrial stromal sarcoma of low grade are not be suggested to receive MHT. Low dose MHT may have lighter adverse reactions while improve menopausal symptoms. The reports of the therapeutic advantages in gynecologic cancer patients increase day by day, but there have been no large-scale studies about it. In clinical use, we should give individual MHT combining with the situation. The application of MHT in gynecological malignant tumors is remained to be explored. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effectiveness and safety of different treatments in stage Ⅱ B cervical cancer. Methods: Databases including PubMed, EMBase, Medline, The Cochrane Library (Issue 12, 2014), CBM, CNKI, VIP and WanFang Data were search. According to the inclusion and exclusion criteria, two reviewers identified literature, extracted data and assessed quality independently. Then meta-analysis was performed using RevMan 5.3 software. Results:Three RCTs, one prospective trials, seventeen case-control studies involving 2 486 patients were included. NACT group compared with RS group, survival has not yet found statistically significant difference, the intraoperative blood loss, operation time, lymph node metastasis rate and postoperative complications of the former is lower than the latter. The 5-years OS and the incidencerate of radioactive cystitis are not statistical differences between multimodality therapy of surgery and concurrent chemoradiation. The incidence rate of radioactive cystitis of the former is less than the latter. The multimodality therapy of surgery compared with radiotherapy, there are no statistical differences in 3-year OS and the rate of fistula formation, but the 5-year OS of the former higher than the latter, the rate of radioactive enteritis of the former is lower than the latter. The gastrointestinal reaction's rate and hematological toxicity's rate are lower in the radiotherapy alone group than the concurrent chemoradiation group. Conclusions:The multimodality therapy of surgery treatment of stage ⅡB cervical cancer is the most effective treatment. Compared with RS, itcould reduce the intraoperative blood loss, operation time, lymph node metastasis rate and postoperative complications. Adverse reaction rate is lower than radiotherapy or concurrent chemoradiation. Therefore the multimodality therapy of surgery is more beneficial to improve the quality of life after treatment. [ABSTRACT FROM AUTHOR]