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Staging for Cervical Cancer
Can be done under anaesthesia
 WHO recommends downstaging
Aim is to obtain adequate Histological specimen for
conformation (90% are SCC and 10 - 15% are
adenocarcinoma)
Stage IA
Cancer confined to the cervix
Stage IB
Stage II A
Cancer beyond cervix extending to
upper 1/3 vagina
Stage II B
Cancer beyond the cervix extending to
para-metrium
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Stage III A - Cancer beyond the cervix extending
distal portion of the vagina.
Stage III B - Cancer beyond the cervix extending
to pelvic side wall.
Stage IV A/IV B - Cancer has spread to bladder/
rectum and can involve distant metastasis (in
stage IV B)
N.B Stage IB1 - diameter cancer < 4cm
Stage IB2 - diameter cancer > 4cm
Most operable cervical cancers are stage II A and
Below:
Aim of surgery is to remove entire margins of
tumour and any metastatic disease in the pelvis.
 Extended Hysterectomy and bilateral pelvic
lymphadenectomy (“Wetheims” “Meigs”).
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Remove uterus with its parematrium, cervix and
paracervical tissue, vaginal cuff, Right and Left
pelvic lymph nodes.
Post-surgical radiotherapy must be offered to
women with incomplete resection margins and
those with metastatic pelvic nodes.
Stage 1B2 is best treated by initial radiation
therapy before surgical intervention.
Complications
Anaesthetic
 Haemorrhage
 Damage urinary/bowel systems
 Infection (UTI/Pelvic/Wound/Atelactosis)
 Lymphoecele
 DVT
Preservation of ovaries
Preservation of functional vagina
Radiotherapy can be used to treat all stages of
cervical cancer and is the only option available for
the non-operable stage II B and above.
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