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Chuang LT, Temin S, Camacho R, et al. Management and Care of Women With Invasive Cervical Cancer: American Society of Clinical Oncology Resource-Stratified Clinical Practice Guideline. J Glob Oncol. 2016;2(5):311-340doi: 10.1200/JGO.2016.003954.
Chuang, L. T., Temin, S., Camacho, R., Dueñas-Gonzalez, A., Feldman, S., Gultekin, M., Gupta, V., Horton, S., Jacob, G., Kidd, E. A., Lishimpi, K., Nakisige, C., Nam, J. H., Ngan, H. Y. S., Small, W., Thomas, G., & Berek, J. S. (2016). Management and Care of Women With Invasive Cervical Cancer: American Society of Clinical Oncology Resource-Stratified Clinical Practice Guideline. Journal of global oncology, 2(5), 311-340. https://doi.org/10.1200/JGO.2016.003954
Chuang, Linus T, et al. "Management and Care of Women With Invasive Cervical Cancer: American Society of Clinical Oncology Resource-Stratified Clinical Practice Guideline." Journal of global oncology vol. 2,5 (2016): 311-340. doi: https://doi.org/10.1200/JGO.2016.003954
Chuang LT, Temin S, Camacho R, Dueñas-Gonzalez A, Feldman S, Gultekin M, Gupta V, Horton S, Jacob G, Kidd EA, Lishimpi K, Nakisige C, Nam JH, Ngan HYS, Small W, Thomas G, Berek JS. Management and Care of Women With Invasive Cervical Cancer: American Society of Clinical Oncology Resource-Stratified Clinical Practice Guideline. J Glob Oncol. 2016 May 25;2(5):311-340. doi: 10.1200/JGO.2016.003954. eCollection 2016 Oct. PMID: 28717717; PMCID: PMC5493265.
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J Glob Oncol. 2016 May 25;2(5):311-340. doi: 10.1200/JGO.2016.003954. eCollection 2016 Oct.

Management and Care of Women With Invasive Cervical Cancer: American Society of Clinical Oncology Resource-Stratified Clinical Practice Guideline.

Journal of global oncology

Linus T Chuang, Sarah Temin, Rolando Camacho, Alfonso Dueñas-Gonzalez, Sarah Feldman, Murat Gultekin, Vandana Gupta, Susan Horton, Graciela Jacob, Elizabeth A Kidd, Kennedy Lishimpi, Carolyn Nakisige, Joo-Hyun Nam, Hextan Yuen Sheung Ngan, William Small, Gillian Thomas, Jonathan S Berek

Affiliations

  1. , Icahn School of Medicine at Mt Sinai, New York, NY; , American Society of Clinical Oncology, Alexandria, VA; , retired, Mallorca, Spain; , Instituto Nacional de Cancerologia, Mexico City, Mexico; , Dana-Farber Cancer Institute and Brigham and Women's Hospital, Boston, MA; , Turkish Ministry of Health, Ankara, Turkey; , patient representative, V Care Foundation, Mumbai, India; , University of Waterloo, Waterloo; , Sunnybrook Odette Cancer Centre and University of Toronto, Toronto, Ontario, Canada; , Instituto Nacional de Cancerologia, Buenos Aires, Argentina; and , Stanford Comprehensive Cancer Institute, Stanford, CA; , Cancer Diseases Hospital, Lusaka, Zambia; , Mulago Hospital, Kampala, Uganda; , Asan Medical Center, Seoul, South Korea; , University of Hong Kong, Hong Kong, Special Administrative Region, People's Republic of China; and , Cardinal Bernardin Cancer Center, Stritch School of Medicine, Loyola University, Chicago, IL.

PMID: 28717717 PMCID: PMC5493265 DOI: 10.1200/JGO.2016.003954

Abstract

PURPOSE: To provide evidence-based, resource-stratified global recommendations to clinicians and policymakers on the management and palliative care of women diagnosed with invasive cervical cancer.

METHODS: ASCO convened a multidisciplinary, multinational panel of cancer control, medical and radiation oncology, health economic, obstetric and gynecologic, and palliative care experts to produce recommendations reflecting resource-tiered settings. A systematic review of literature from 1966 to 2015 failed to yield sufficiently strong quality evidence to support basic- and limited-resource setting recommendations; a formal consensus-based process was used to develop recommendations. A modified ADAPTE process was also used to adapt recommendations from existing guidelines.

RESULTS: Five existing sets of guidelines were identified and reviewed, and adapted recommendations form the evidence base. Eight systematic reviews, along with cost-effectiveness analyses, provided indirect evidence to inform the consensus process, which resulted in agreement of 75% or greater.

RECOMMENDATIONS: Clinicians and planners should strive to provide access to the most effective evidence-based antitumor and palliative care interventions. If a woman cannot access these within her own or neighboring country or region, she may need to be treated with lower-tier modalities, depending on capacity and resources for surgery, chemotherapy, radiation therapy, and supportive and palliative care. For women with early-stage cervical cancer in basic settings, cone biopsy or extrafascial hysterectomy may be performed. Fertility-sparing procedures or modified radical or radical hysterectomy may be additional options in nonbasic settings. Combinations of surgery, chemotherapy, and radiation therapy (including brachytherapy) should be used for women with stage IB to IVA disease, depending on available resources. Pain control is a vital component of palliative care. Additional information is available at www.asco.org/rs-cervical-cancer-treatment-guideline and www.asco.org/guidelineswiki. It is the view of ASCO that health care providers and health care system decision makers should be guided by the recommendations for the highest stratum of resources available. The guideline is intended to complement but not replace local guidelines.

Conflict of interest statement

Authors’ disclosures of potential conflicts of interest and author contributions are found at the end of this article. The following represents disclosure information provided by authors of this manus

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