Cervical Cancer Staging Criteria

Written by Gong Chun
Oncology
Updated on September 04, 2024
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For the staging of cervical cancer, the staging criteria of the International Federation of Gynecology and Obstetrics (FIGO) are now adopted. Staging should be done before treatment, and since the FIGO staging of the cervix mainly relies on the examination of the pelvis, it is emphasized that the pelvic examination must be performed by two senior gynecologic oncologists. The staging primarily involves assessing the size of the cervical lesion, particularly the measurement of endophytic tumors, parametrial tissue infiltration, and the status of pelvic lymph nodes. However, these stages mainly rely on radiological examinations, primarily magnetic resonance imaging (MRI), to provide objective data for staging.

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Written by Gong Chun
Oncology
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Causes of Cervical Cancer

The causes of cervical cancer include: The first point is infection by the human papillomavirus (HPV), particularly persistent infection with high-risk types, which is the basic cause of precancerous lesions and cervical cancer. The second point is that DNA from HPV is not detected in the tumor tissues of a minority of cases, especially among some older patients. Epidemiology shows that early childbirth and multiparity are closely related to the occurrence of cervical cancer. With an increasing number of childbirths, the risk of cervical cancer also increases. This correlation might be due to the trauma to the cervix during childbirth and changes to the endocrine and nutritional states during pregnancy.

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Written by Gong Chun
Oncology
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Staging of cervical cancer

The clinical staging of cervical cancer mainly uses the FIGO system, which adopts the staging criteria of the International Federation of Gynecology and Obstetrics (FIGO). Staging should be performed before treatment, and once done it does not change after treatment. Since FIGO staging of cervical cancer primarily relies on pelvic examination, it emphasizes the necessity of this examination being conducted by two experienced gynecologic oncologists. If needed, a pelvic examination under anesthesia is performed to ensure the accuracy of the evaluation. So, how is the staging performed? It involves measuring the size of the cervical lesion, particularly the measurement of endophytic tumors, the infiltration of cervical tissue, and the status of pelvic lymph nodes, providing accurate information with the aid of radiological data, especially magnetic resonance imaging (MRI).

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Written by Gong Chun
Oncology
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Treatment of Cervical Cancer

The treatment principle of cervical cancer primarily focuses on surgical and radiotherapy, supplemented by chemotherapy and other comprehensive treatment plans. Therefore, it should be based on clinical staging and the specific condition of the patient, such as age and physical health, combined with the overall situation, as well as considering the level of technology and equipment conditions to develop a suitable treatment plan. Nowadays, emphasis is placed on personalized treatment and initial treatment. Cervical cancer treatment primarily involves surgery, including extensive hysterectomy and extensive cervical excision, where choosing the appropriate surgical method is key. Post-surgery, radiotherapy can be combined, and for those unsuitable for surgery, preoperative radiotherapy is an option. Additionally, preoperative or postoperative adjuvant chemotherapy can also be considered.

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Written by Gong Chun
Oncology
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Characteristics of Bleeding in Cervical Cancer

The bleeding characteristics of cervical cancer should be considered based on the pathological type and stage of the disease. In the early stages, the bleeding may be contact-related, occurring after sexual intercourse or a gynecological examination, and may involve a small amount of fresh, light bleeding. As the disease progresses into the later stages, the tumor may cause irregular vaginal bleeding. The amount of this irregular bleeding varies, depending on the size of the lesion and the involvement of the blood vessels in the interstitial tissues. A larger lesion may naturally result in more bleeding. In advanced stages, major blood vessels may be affected, potentially leading to severe bleeding. Therefore, the characteristics of vaginal bleeding should be analyzed based on the specific circumstances. If the cancer is exophytic, bleeding tends to occur earlier and is usually more copious, whereas if it is endophytic, bleeding tends to occur later.

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Written by Zhang Xiu Rong
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Symptoms of cervical cancer

The most typical early symptom of cervical cancer is usually contact bleeding during intercourse. Clinically, once contact bleeding occurs, it is essential to go to the hospital for cervical cancer screening as soon as possible, generally involving a cervical TCT and HPV test. These two tests can initially screen for the presence of cervical cancer and precancerous lesions. If it has progressed to the stage of cervical cancer, there may be a large amount of vaginal discharge with a foul smell, and severe cases can have symptoms like bleeding and abdominal pain. Therefore, patients with cervical cancer must undergo relevant cervical examinations at the hospital. If it is indeed cervical cancer, treatment options should be selected based on the stage of the disease to treat the symptoms accordingly. Hence, if there is any irregular vaginal bleeding, it is critical to go to the hospital for the relevant cancer screening.