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2019 | OriginalPaper | Hoofdstuk

25. Cervical premalignancies and cervical cancer

Auteurs : Dr Ruud L. M. Bekkers, Dr Jurgen M. J. Piek

Gepubliceerd in: Textbook of Obstetrics and Gynaecology

Uitgeverij: Bohn Stafleu van Loghum

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Summary

Cervical premalignancies are caused by an asymptomatic infection with high-risk human papilloma virus (hr-HPV). Most women clear these infections; however, a subset remains infected. Such an infection can lead to premalignancies, which can be picked up by the national screening program with PAP smears. Women with abnormal PAP smears are referred, by their general practitioner, to the gynaecologist for a colposcopy. When abnormalities are detected, biopsies are taken to histologically confirm the suspicion. High-grade lesions are treated by removing the abnormal area by a loop electrosurgical excision procedure (LEEP). If a high-grade lesion remains undetected or is left untreated, cervical cancer may develop. Nowadays, vaccination against hr-HPV may prevent this type of tumour. In case of diagnosis of cervical cancer a systematic, multidisciplinary workup is needed. The FIGO stage of disease needs to be established and is purely based on physical examination. In the Netherlands an MRI scan of the small pelvis is recommended in suspected early stage disease. In case of suspected higher stage disease a PET-CT scan is warranted. Surgery is the cornerstone of curative treatment in localized disease. With locally advanced disease, chemoradiation therapy with curative intent is the cornerstone of treatment. Prognosis for early stage disease is very good.
Bijlagen
Alleen toegankelijk voor geautoriseerde gebruikers
Woordenlijst
Colposcopy
Examination of the cervix by magnification and application of colouring fluids in order to identify premalignant or malignant abnormalities of the cervix
Acetowhitening
Tissue reaction by colouring the tissue white 1–3 minutes after application of acetic acid to the tissue
Conization
Excision of a conus shaped part of the cervix as treatment for the abnormality
Squamous cell cervical cancer
Cancer originating from squamous cells that are present on the outer part of the uterine cervix
Adenocarcinoma of the cervix
Cancer originating from cylindrical cells that are present on the inner part of the uterine cervix
Chemoradiation
During the 5 weeks of radiation treatment, patients receive low-dose chemotherapy in order to increase radiation efficacy, because it acts as a radiosensitizer
Literatuur
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Metagegevens
Titel
Cervical premalignancies and cervical cancer
Auteurs
Dr Ruud L. M. Bekkers
Dr Jurgen M. J. Piek
Copyright
2019
Uitgeverij
Bohn Stafleu van Loghum
DOI
https://doi.org/10.1007/978-90-368-2131-5_25