20 Jun

PhD Defence Kim Gosewina Gerarda van Kol

Supervisor: Prof. dr. R.L.M. Bekkers

Co-supervisors: Dr. R.M.F. Ebisch, Dr. J.M.J. Piek

Keywords: Cervical cancer, FIGO classification, Residual disease, Fertility sparing

"Treatment determinants in cervical cancer"

This thesis investigates treatment determinants in women with cervical cancer. This thesis investigated the influence of lymph node metastases on survival rates. This thesis concludes that the survival rates for women with early-stage cervical cancer are significantly affected by the presence of these lymph node metastases. This thesis also shows that lymph node dissection can be considered in a select group of patients now staged as IA instead of IB due to the revision of the FIGO classification. Furthermore, this thesis concludes that standard adjuvant surgery after chemoradiation for patients with locally advanced cervical cancer must be omitted, 66% of the patients is overtreated. The advised procedure for follow-up is an MRI scan, when residual disease is suspected a biopsy must be taken before performing salvage surgery. In this way, less women are unnecessarily exposed to the risks and complications of salvage surgery. Lastly, we conclude that women with early-stage cervical cancer and a future desire to have children, can be safely operated with neoadjuvant chemotherapy followed by a vaginal radical trachelectomy.

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