The prognosis of patients with cervical cancer has improved dramatically in the last 20 years due to the success of systematic screening programs; however, the disease remains a major health problem worldwide. Patients with advanced, recurrent or metastatic disease still have a poor prognosis. Over the last century, radical surgery and radiotherapy have been used to improve survival rates in patients with primary cervical cancer. Both methods have been extensively modified over the years; however, neither improvements in surgical therapy (e.g. radical lymph node dissection) nor modified radiotherapy methods (e.g. neutron irradiation, hyperthermia, interstitial brachytherapy) have significantly decreased the mortality rates. Recently, cooperative clinical trials have demonstrated the superiority of multimodality strategies for patients with high-risk cervical cancer. In these studies, chemotherapy has been integrated into primary therapy; results have shown the most significant improvement of locally advanced disease in more than three decades. The introduction of modern surgical techniques, such as laparoscopic lymphonodectomy and radical pelvic exenteration, are new developments that will change the treatment of cervical cancer in the near future. This review summarizes different aspects of cervical cancer therapy, with emphasis on invasive disease, and provides a perspective on developments which may improve both local and systemic treatment of the disease.
American Journal of Cancer – Springer Journals
Published: Aug 9, 2012