2023ESGOESTROESP指南：宫颈癌患者的管理（更新版）

Virchows Archivhttp5/doi.org/10.1007/s00428-023-03552-3ORIGINAL ARTICLEESGO/ESTRO/ESP Guidelines for the management of patientswith cervical cancer-Update 2023*David Cibula12.Maria Rosaria Raspollini3.Francois Planchamp.Carlos Centeno5.Cyrus Chargaris.Ana Felix78.Daniela Fischerova2.Daniela Jahnn-Kuch.Florence Joly10.Christhardt Kohler11.12.Sigurd Lax314.Domenica Lorusso1516.Umesh Mahantshetty17.Patrice Mathevet.Raj Naik.RemiA.Nout2021.Ana Oaknin2223.Fedro Peccatori24.Jan Persson25,26.Denis Querleu 1527.Sandra Rubio Bernabe28.Maximilian P.Schmid29.Artem Stepanyan30.Valentyn Svintsitskyi31.Karl Tamussino32.Ignacio Zapardiel33.Jacob Lindegaard34Received:20 April 2023/Revised:20 April 2023/Accepted:24 April 2023©ESG0,ESTR0,ESP2023AbstractIn 2018,the European Society of Gynecological Oncology (ESGO)jointly with the European Society for Radiotherapy andOncology(ESTRO)and the European Society of Pathology (ESP)published evidence-based guidelines for the managementof patients with cervical cancer.Given the large body of new evidence addressing the management of cervical cancer,thethree sister societies jointly decided to update these evidence-based guidelines.The update includes new topics to providecomprehensive guidelines on all relevant issues of diagnosis and treatment in cervical cancer.To serve on the expert panel(27 experts across Europe)ESGO/ESTRO/ESP nominated practicing clinicians who are involvedin managing patients with cervical cancer and have demonstrated leadership through their expertise in clinical care andresearch,national and international engagement,profile,and dedication to the topics addressed.To ensure the statementswere evidence based,new data identified from a systematic search was reviewed and critically appraised.In the absence ofany clear scientific evidence,judgment was based on the professional experience and consensus of the international develop-ment group.Before publication,the guidelines were reviewed by 155 independent international practitioners in cancer caredelivery and patient representatives.These updated guidelines are comprehensive and cover staging,management,follow-up,long-term survivorship,quality oflife and palliative care.Management includes fertility sparing treatment,early and locally advanced cervical cancer,invasivecervical cancer diagnosed on a simple hysterectomy specimen,cervical cancer in pregnancy,rare tumors,recurrent and meta-static diseases.The management algorithms and the principles of radiotherapy and pathological evaluation are also defined.Keywords Cervical cancer·Pathology·Radiation·Surgical oncologyIntroductionin the prevalence of human papillomavirus(HPV)infectionand inequalities in access to adequate screening and treat-Cervical cancer is a major public health problem,rankingment [1].Cervical cancer is uncommon in Europe but stillas the fourth most common cause of cancer incidence andremains the most frequent cause of cancer death in middle-mortality in women world wide.There are geogra