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: 13,800 (Estimated new cases for 2020 in the United States) Stage at Presentation Localized: 44% 7.3 per 100,000 women per year Regional: 36% Deaths: Estimated 4290 in 2020 Distant: 15% Median age: 50 years Unstaged: 4% Siegel R et al. CA Cancer J Clin 2020;70:7-30 Surveillance, Epidemiology and End Results (SEER) Program, available from http://seer.cancer.gov [accessed June 2020] ++ 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 MRI ± PET Stage IB2 or greater: 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 HPV associated Usual endocervical (villoglandular and micropapillary variants) Mucinous Intestinal Signet ring Adenosquamous (Invasive stratified mucin-producing carcinoma variant) Non-HPV associated✫ Gastric Clear cell Endometrioid Mesonephric 23% Glassy cell carcinoma Rare Neuroendocrine small cell carcinoma Rare ✫ NonHPV Associated adenocarcinomas more often have lymphovascular invasion and lymph node metastases, and are associated with worse survival Hunter RD in: Souhami RL et al editors. Oxford Textbook of Oncology, 2nd ed., New York, Oxford University Press 2002:1835-1837 Stolnicu S, et al. Virchows Archiv 2019; 475:537-49. 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 FIGO Stage (2018) I Cervical carcinoma is strictly confined to uterus (extension to corpus should be disregarded) IA Invasive carcinoma diagnosed only by microscopy, with maximum depth of invasion <5 mm✫ IA1 Measured stromal invasion <3 mm in depth IA2 Measured stromal invasion ≥3 mm and <5 mm in depth IB Invasive carcinoma with measured deepest invasion ≥5 mm (greater than stage IA), lesion limited to the cervix uteri† IB1 Invasive carcinoma ≥5 mm depth of stromal invasion and <2 cm in greatest dimension IB2 Invasive carcinoma ≥2 cm and <4 cm in greatest dimension IB3 Invasive carcinoma ≥4 cm in greatest dimension II The carcinoma invades beyond the uterus, but has not extended onto the lower third of the vagina or to the pelvic wall IIA Involvement limited to the upper two-thirds of the vagina without parametrial involvement IIA1 Invasive carcinoma <4 cm in greatest dimension IIA2 Invasive carcinoma ≥4 cm in greatest dimension IIB With parametrial involvement but not up to the pelvic wall III The carcinoma involves the lower third of the vagina and/or extends to the pelvic wall and/or causes hydronephrosis or non-functioning kidney and/or involves pelvic and/or paraaortic lymph nodes‡ IIIA Carcinoma involves the lower third of the ... 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? Download the Access App: iOS | Android 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.