In light of the SHAPE trial results, how would you manage a patient with an incidentally diagnosed FIGO IA1 cervical cancer after simple extrafascial hysterectomy/BSO?

Topics: Radiation Oncology • Gynecologic Cancers • Cervical Cancer

No LN dissection was performed as it was for a suspected CIN III. Final pathology showed +LVSI, -margins (>10mm), -parametrial extension, and 1.2mm depth of invasion.

Answer from: Radiation Oncologist at Academic Institution

Without question, I would recommend that this patient receive pelvic RT and probably cuff brachytherapy as well. The SHAPE trial (NCT01658930) enrolled "low risk" patients, but they allowed LVSI patients into the trial, even though this is a high risk feature for local recurrence. There were approxi...

Comments

Radiation Oncologist at University of California Irvine Medical Center
Thank you! I agree with adjuvant pelvic radiation ...

Radiation Oncologist at University of Kentucky
I would either add vaginal cuff brachy or do an SI...

Radiation Oncologist at Harold C Simmons Comprehensive Cancer Center/UT Southwestern
Agree with the answers

Answer from: at Academic Institution

If one uses the mm diagnosis of Stage IA cancer (the previous FIGO staging) then there is a ton of data that shows that hysterectomy is adequate therapy.

Comments

Radiation Oncologist at University of Kentucky
In the case described, the patient had +LVSI. Ther...

at Medical University of South Carolina
Again if the previous mm staging is used, LVSI did...

Radiation Oncologist at University of Kentucky
Changing the staging system does not change the pr...

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