[Guideline for gynecological malignant tumors--primary complex therapy in operable stages of malignant tumors of uterus cervix].

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.