What is your approach for treating locally-advanced gastric-type adenocarcinoma of the cervix?

We still treat with definitive chemo RT (cis) but if operable, then favor surgery first.

Recommendation:

There are no specific guidelines for the management of gastric endocervical adenocarcinoma (GEA), a rare, aggressive, non-HPV associated endocervical malignancy.¹ Despite clinical and genomic differences between GEA and HPV-related cervical cancers, locally advanced GEA is generally t...

We still use standard cisplatin based chemo radiation and image guided adaptive brachytherapy.

Same. Pathways for locally advanced are the same with cis-RT. Brachy we aim for higher doses to HRCTV since adeno histology. We don’t perform routine adjuvant hysterectomies. Surgery is reserved for persistent or recurrent disease.

Lack of evidence, of course, doesn't indicate a lack of benefit, but without evidence for benefit to an intervention, I cannot recommend a routine practice that clearly adds morbidity.

Therefore, I favor limiting completion hysterectomy in this case to the rare group of patients who, as NCCN mention...