Cervical cancer survival rates vary widely between regions and countries. When cervical cancer has spread just locally, it is called locally advanced cervical cancer (LACC), and it has a much lower survival rate than early-stage illness. Differences in LACC outcomes may be attributable to country-specific diagnostic and treatment guideline variances. Researchers evaluated diagnostic imaging and therapy recommendations for LACC based on international and country-specific guidelines. Using a broad search and a more specific literature analysis, they could locate treatment guidelines for cervical cancer that were published from January 1999 through August 2021.
Guidelines were located using systematic literature searches, health technology evaluation databases, disease-specific websites, and health organization websites. The guidelines for countries with a high prevalence or mortality rate of cervical cancer were included in the targeted search. Instructions written in languages other than English were translated by native speakers or machine translation providers. They analyzed 46 guidelines from 31 nations, regions, and international organizations (41% of which employed staging criteria, with 27% utilizing the 2009 FIGO). Many diagnostic and staging standards included the use of imaging. Diagnostic imaging techniques such as chest X-ray, intravenous pyelogram, CT, and MRI were indicated frequently, whereas MRI and PET-CT were preferred for evaluating lymph node status and distant metastases. The primary treatment for stages IIB to IVA was generally agreed upon as cisplatin-based concurrent chemoradiation.
Treatment recommendations differed between phases IB2 and IIA2. When the risk of recurrence is high, most guidelines recommend adjuvant concurrent chemoradiation after radical hysterectomy, whereas those for moderate risk recommend adjuvant radiotherapy. Guidelines differed in their suggestions for additional adjuvant and neoadjuvant therapy. Staging criteria, available resources, and the efficacy of preventative programs may all play a role in why there are variations in treatment recommendations between LACC stages. Guidelines could be unified, and worldwide outcomes could be improved if addressed. It will be crucial to review and update guidelines as new LACC medicines become available.