[Diagnosis and therapy of cervical squamous epithelial carcinomas]. / Diagnostik und Therapie zervikaler Plattenepithelkarzinome.

ABSTRACT

The clinical management of cervical carcinomas is solely based upon the FIGO-staging system. Therefore clinical staging is crucial for primary therapy of cervical carcinomas. Accurate morphologic evaluation of the surgical specimens completes the clinical staging and determines postoperative procedures and the individual prognosis. The most important morphologic prognostic factors include stromal invasion, vascular space involvement, tumor volume and surgical margins (pelvic recurrence, metastasic dissemination, survival). The prognostic and therapeutic importance of tumor biological markers is presently controversial. Radical surgical therapy (Wertheim-Meigs surgery) and primary or adjuvant pelvic radiation are currently the basic therapeutic modalities for invasive cervical carcinomas. The role of chemotherapy still needs to be defined. A less radical therapeutic approach is performed for microinvasive cervical carcinomas depending on the extent of stromal invasion, the presence of vascular space involvement and the surgical margins.