On May 25, 2016, the American Society of Clinical Oncology (ASCO) released evidence-based, resource-stratified global recommendations on the management and palliative care of women diagnosed with invasive cervical cancer. The Society of Gynecologic Oncology and the Gynecologic Cancer Intergroup have endorsed the guidelines.
ASCO convened a multidisciplinary, multinational panel of experts to review the literature and draft evidence-based recommendations that they further stratified according to available resources.
Clinicians should strive to provide access to the most effective evidence-based antitumor and palliative care interventions. If a woman cannot access these within her own or neighboring country or region, she may need to be treated with lower-tier modalities, depending on capacity and resources for surgery, chemotherapy, radiation therapy, and supportive and palliative care.
For women with early-stage cervical cancer in basic settings, cone biopsy or extrafascial hysterectomy may be performed. Fertility-sparing procedures or modified radical or radical hysterectomy may be additional options in non-basic settings.
Combinations of surgery, chemotherapy, and radiation therapy (including brachytherapy) should be used for women with stage IB to IVA disease, depending on available resources. The guidelines were developed with the intent to complement local guidelines, and can be accessed here.