Guidelines for the Treatment of Recurrent and Metastatic Cervical Cancer

L earning O bjectives After completing this course, the reader will be able to: Describe the natural history and prognosis of patients with recurrent and/or metastatic cervical cancer. Be able to select appropriate treatment options for patients with recurrent cervical cancer. Be able to identify which patients with locally recurrent cervical cancer are potentially curable with pelvic exenterative surgery. Describe the role and limitations of chemotherapy in the treatment of patients with metastatic cervical cancer.Access and take the CME test online and receive one hour of AMA PRA category 1 credit at CME.TheOncologist.com Although there have been important advances in the management of women with cervical cancer, the optimal treatment for patients with locally recurrent and metastatic disease is still problematic, and there are relatively few randomized trials to guide treatment decisions. This paper reviews the approach to management of patients who relapse after primary treatment for cervical cancer. Patients who are still potentially curable with radical treatment are identified, and the various treatment strategies are discussed. However, most women are treated with palliative intent, and the literature on palliative management is reviewed together with the levels of evidence.