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What is your approach for treating locally-advanced gastric-type adenocarcinoma of the cervix?
When would you use 5-fluorouracil instead of, or in addition to, cisplatin during chemoradiation? When, if ever, would you offer adjuvant hysterectomy after chemoradiation?
Answer from: Radiation Oncologist at Community Practice
We still treat with definitive chemo RT (cis) but if operable, then favor surgery first.
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Answer from: at Community Practice
Recommendation:There are no specific guidelines for the management of gastric endocervical adenocarcinoma (GEA), a rare, aggressive, non-HPV associated endocervical malignancy.1 Despite clinical and genomic differences between GEA and HPV-related cervical cancers, locally advanced GEA is generally t...
Comments
Radiation Oncologist at Weill Cornell Medical College
It is a rare tumor. I just treated a young patien...
It is a rare tumor. I just treated a young patien...
Answer from: Radiation Oncologist at Community Practice
We still use standard cisplatin based chemo radiation and image guided adaptive brachytherapy.
Answer from: Radiation Oncologist at Academic Institution
Same. Pathways for locally advanced are the same with cis-RT. Brachy we aim for higher doses to HRCTV since adeno histology. We don’t perform routine adjuvant hysterectomies. Surgery is reserved for persistent or recurrent disease.
Answer from: at Academic Institution
Lack of evidence, of course, doesn't indicate a lack of benefit, but without evidence for benefit to an intervention, I cannot recommend a routine practice that clearly adds morbidity.
Therefore, I favor limiting completion hysterectomy in this case to the rare group of patients who, as NCCN mentio...