早期子宫颈癌保留生育功能中国专家共识
本文刊登于《中国实用妇科与产科杂志》2022,38(6):634-641
DOI:10.19538/j.fk2022060114
【引用本文】中国抗癌协会妇科肿瘤专业委员会.早期子宫颈癌保留生育功能中国专家共识[J].中国实用妇科与产科杂志,2022,38(6):634-641.
作者:中国抗癌协会妇科肿瘤专业委员会
基金项目:国家自然科学基金面上项目(81972433);逸仙临床研究培育项目(SYS-C-202001)
通讯作者:吴小华,复旦大学附属肿瘤医院,上海 200030,电子信箱:wu.xh@fudan.edu.cn;林仲秋,中山大学孙逸仙纪念医院,广东 广州 510120,电子信箱:lin-zhongqiu@163.com
执笔者:卢淮武(中山大学孙逸仙纪念医院);李璡(复旦大学附属肿瘤医院)
参与共识编写专家(按姓氏首字母汉语拼音排序):康山(河北医科大学第四医院);刘开江(上海交通大学医学院附属仁济医院);向阳(中国医学科学院北京协和医院);刘颖琳(中山大学孙逸仙纪念医院)
参与共识编写青年专家(按姓氏首字母汉语拼音排序):蔡鸿宁(湖北省妇幼保健院);陈亮(山东省肿瘤医院);陈小军(复旦大学附属肿瘤医院);陈峥峥(安徽省立医院);陈仲波(浙江省肿瘤医院);付欣(天津市肿瘤医院);高军(南昌大学第三附属医院);韩志红(陕西省肿瘤医院);姜伟(复旦大学附属妇产科医院);蒋芳(中国医学科学院北京协和医院);李虎(广州市番禺中心医院);李金凤(首都医科大学附属北京朝阳医院);李宁(中国医学科学院肿瘤医院);李雨聪(重庆大学附属肿瘤医院);李蓁(武汉大学中南医院);刘金钰(吉林省肿瘤医院);刘青(上海交通大学医学院附属仁济医院);刘若男(河南省肿瘤医院);刘运铎(哈尔滨医科大学附属肿瘤医院妇科);龙行涛(重庆大学附属肿瘤医院);苏涛(上海交通大学医学院附属国际和平妇幼保健院);佟锐(辽宁省肿瘤医院);涂开家(江西省妇幼保健院);王登凤(四川省肿瘤医院);王芬芬(浙江大学医学院附属妇产科医院);王伟(山西医科大学第二医院);杨琳琳(云南省肿瘤医院);张娜(天津市中心妇产科医院);赵冰冰(广西医科大学附属肿瘤医院);赵丹(中国医学科学院肿瘤医院);赵喜娃(河北医科大学第四医院)
秘书:刘昀昀(中山大学孙逸仙纪念医院);李晓琦(复旦大学附属肿瘤医院)
1 早期子宫颈癌保留生育功能的适应证
推荐意见:早期子宫颈癌保留生育功能手术适应证包括:(1)有强烈的生育愿望(推荐级别:2A类)。(2)年龄≤45岁(推荐级别:2A类)。(3)影像学提示病灶局限于子宫颈,病灶未侵犯子宫颈内口(推荐级别:2A类)。(4)FIGO分期ⅠA1~ⅠB2期患者(推荐级别:2A类)。(5)无淋巴结转移(推荐级别:2A类)。(6)病理确认为子宫颈鳞癌、腺癌和腺鳞癌,排除神经内分泌癌、胃型腺癌等特殊病理类型(推荐级别:2A类)。
2 早期子宫颈癌保留生育功能术前评估
3 早期子宫颈癌保留生育功能手术类型
4 盆腔淋巴结切除方法
5 根治性子宫颈切除术的手术途径
6 根治性子宫颈切除术的手术范围
7 子宫颈环扎
8 子宫动脉的处理
9 子宫颈狭窄的预防
10 子宫颈阴道重建方法
11 预防子宫脱垂
12 术后辅助治疗
推荐意见:RT术后对于存在中危因素(肿瘤直径≥3cm,深肌层浸润>1/2,伴LVSI)的患者可考虑实施紫杉醇联合卡铂化疗3~6个疗程,化疗期间同时使用促性腺激素释放激素激动剂(GnRH-a)保护卵巢(推荐级别:2B类)。
13 新辅助化疗
14 RT术后妊娠相关问题
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