Cervical cancer - from curative therapies to palliative approach.

Cervical cancer ranks second worldwide in the malignancies in women, with an incidence of approximately 528,000 new cases reported annually and approximately 266,000 deaths reported in 2012. There is a strong link between the presence of human papillomavirus (HPV) cervical cancer and its precursors. HPV can be identified in more than 99% of all cases of cervical cancer and HPV infection is now accepted as a necessary cause for the majority of cervical cancers. All patients diagnosed with invasive cervical carcinoma should be evaluated clinically by vaginal exam and rectal imaging by computed tomography, magnetic resonance imaging or PET-CT. FIGO system is most widely used staging system for cervical cancer. FIGO staging system is mainly based on clinical examination, pelvic examination therefore performed by a clinician with experience, which is critically important. Many factors influence the choice of treatment for cervical cancer, including tumour size, stage, histological characteristics and lymph node invasion obvious risk factors for complications after surgery or radiotherapy and patients' preferences. Basically, in micro invasive carcinoma (std. IA1) the treatment of choice is conservative surgery (excisional conisation or hysterectomy extra fasciala). In invasive cancers in early stages (std. IA2, IB1, some IIA) the treatment of choice is radical hysterectomy or modified radical hysterectomy, radical trachelectomia (if desired fertility preservation) or radiotherapy. In locally advanced cancers (std. IB2 to IVA) the treatment of choice is radio chemotherapy. Treatment of patients with metastatic disease is primarily systemic chemotherapy, but the patients are encouraged to participate in clinical trials. [ABSTRACT FROM AUTHOR]