J Gynecol Oncol.  2016 Jul;27(4):e43. 10.3802/jgo.2016.27.e43.

Advances in diagnosis and treatment of metastatic cervical cancer

• Li H
• Wu X
• Cheng X

• KMID: 2374245
• DOI: http://doi.org/10.3802/jgo.2016.27.e43

Abstract

Cervical cancer is one of the most common cancers in women worldwide. The outcome of patients with metastatic cervical cancer is poor. We reviewed the relevant literature concerning the treatment and diagnosis of metastatic cervical cancer. There are two types of metastasis related to different treatments and survival rates: hematogenous metastasis and lymphatic metastasis. Patients with hematogenous metastasis have a higher risk of death than those with lymphatic metastasis. In terms of diagnosis, fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) and PET-computed tomography are effective tools for the evaluation of distant metastasis. Concurrent chemoradiotherapy and subsequent chemotherapy are well-tolerated and efficient for lymphatic metastasis. As for lung metastasis, chemotherapy and/or surgery are valuable treatments for resistant, recurrent metastatic cervical cancer and chemoradiotherapy may be the optimal choice for stage IVB cervical cancer. Chemotherapy and bone irradiation are promising for bone metastasis. A better survival is achieved with multimodal therapy. Craniotomy or stereotactic radiosurgery is an optimal choice combined with radiotherapy for solitary brain metastases. Chemotherapy and palliative brain radiation may be considered for multiple brain metastases and other organ metastases.

Keyword

Diagnosis; Neoplasm Metastasis; Therapeutics; Uterine Cervical Neoplasms

MeSH Terms

Bone Neoplasms/secondary/therapy
Brain Neoplasms/secondary/therapy
Chemoradiotherapy
Female
Fluorodeoxyglucose F18
Humans
Lung Neoplasms/secondary/therapy
Lymphatic Metastasis
Positron-Emission Tomography
Uterine Cervical Neoplasms/diagnostic imaging/*pathology/therapy
Fluorodeoxyglucose F18