Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content +++ INTRODUCTION ++ Epidemiology Table Graphic Jump Location|Download (.pdf)|Print Epidemiology Incidence: 12,360 (Estimated new cases for 2014 in the United States) Stage at Presentation Localized: 55% 7.9 per 100,000 women per year Regional: 32% Deaths: Estimated 4020 in 2014 Distant: 8% Median age: 49 years Unstaged: 6% Siegel R et al. CA Cancer J Clin 2013;63:11–30 Surveillance, Epidemiology and End Results (SEER) Program. Available from: <http://seer.cancer.gov>; Accessed 2013 ++ Work-up Table Graphic Jump Location|Download (.pdf)|Print Work-up Stage IA/Stage IB1: H&P CBC with platelet count, LFTs, BUN, creatinine Cervical biopsy (pathologic review) Cone biopsy as indicated Chest x-ray, intravenous pyelogram, for IB1 CT/MRI ± PET ± lymphangiogram Stage IB2 or greater: Chest x-ray, intravenous pyelogram, or CT/MRI ± PET ± lymphangiogram Consider examination under anesthesia Stages III/IV: Consider cystoscopy/proctoscopy ++ Pathology Table Graphic Jump Location|Download (.pdf)|Print Pathology Squamous cell carcinomas Large cell, keratinizing Large cell, nonkeratinizing Small cell (not neuroendocrine) Verrucous carcinoma 75–80% Adenocarcinomas Adenoma malignum Mucinous Papillary Endometrioid Clear cell Adenoid cystic 17% Adenosquamous 6% Glassy cell carcinoma Rare Neuroendocrine small cell carcinoma Rare Galic V et al. Gynecol Oncol. 2012;125:287–291 Hunter RD. In: Souhami RL, Tannock I, Hohenberger P, Horiot J-C, eds. Oxford Textbook of Oncology, 2nd ed. New York: Oxford University Press; 2002:1835–1837 Table Graphic Jump Location|Download (.pdf)|Print Pathology Histologic Grade Gx Cannot be assessed G1 Well differentiated G2 Moderately differentiated G3 Poorly differentiated G4 Undifferentiated ++ Staging Table Graphic Jump Location|Download (.pdf)|Print Staging Primary Tumor (T) TNM Category FIGO Stage TX Primary tumor cannot be assessed T0 No evidence of primary tumor Tis ✫ Carcinoma in situ (preinvasive carcinoma) T1 I Cervical carcinoma confined to uterus (extension to corpus should be disregarded) T1a† IA Invasive carcinoma diagnosed only by microscopy. Stromal invasion with a maximum depth of 5.0 mm measured from the base of the epithelium and a horizontal spread of 7.0 mm or less. Vascular space involvement, venous or lymphatic, does not affect classification T1a1 IA1 Measured stromal invasion 3.0 mm or less in depth and 7.0 mm or less in horizontal spread T1a2 IA2 Measured stromal invasion more than 3.0 mm and not more than 5.0 mm with a horizontal spread 7.0 mm or less T1b IB Clinically visible lesion confined to the cervix or microscopic lesion greater than T1a/IA2 T1b1 IB1 Clinically visible lesion 4.0 cm or less in greatest dimension T1b2 IB2 Clinically visible lesion more than 4.0 cm in greatest dimension T2 II Cervical carcinoma invades beyond uterus but not to pelvic wall or to lower third of vagina T2a IIA Tumor without parametrial invasion T2a1 IIA1 Clinically visible lesion 4.0 cm or less in greatest dimension T2a2 IIA2 Clinically visible lesion more than 4.0 cm in greatest dimension T2b IIB Tumor with parametrial invasion T3 III Tumor extends to pelvic wall and/or involves ... Your Access profile is currently affiliated with [InstitutionA] and is in the process of switching affiliations to [InstitutionB]. Please select how you would like to proceed. Keep the current affiliation with [InstitutionA] and continue with the Access profile sign in process Switch affiliation to [InstitutionB] and continue with the Access profile sign in process Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Error: Incorrect UserName or Password Username Error: Please enter User Name Password Error: Please enter Password Sign in Forgot Password? Forgot Username? Sign in via OpenAthens Sign in via Shibboleth You already have access! Please proceed to your institution's subscription. Create a free profile for additional features.