Treatment Progress of Cervical Adenocarcinoma

WEN Qiang; FANG Su-hua

Abstract：The optimal treatment pattern for cervical adenocarcinoma is still undefined. Patients with ceruical adenocarcinoma in situ often need a simple hysterectomy. But to young patients ,fertility-sparing surgeries such as cervical conization and LEEP are also options. To stageⅠA1 cervical adenocarcinoma,simple hysterectomy is much more used than radical hysterectomy now,but to young patients,cervical conization is also appropriate. The choice of treatment for most women with stage ⅠA2 to ⅡA disease is radical hysterectomy plus lymphedenectomy. Some patients require platinum based chemoradiation after surgery because of high-risk surgical-pathologic features. Primary radiation with weekly Cisplatin may be the best option for patients with stageⅡB toⅣA cervical adenocarcinoma. Furthermore ,Paclitaxel with Cisplatin can be used as neo-adjuvant chemotherapy before radiation or as consolidation chemotherapy following radiation. To choose a treatment forⅣB diseases is always difficult. Sometimes a palliative chemotherapy such as Paclitaxel plus Carboplatin or Gemcitabine plus Cisplatin is needed. Patients with local advanced or bulky diseases are difficult to deal with. Neo-adjuvant chemotherapy can be used to shrink the tumor. But whether it can prolong survival is still controversial. Management of relapsed or persistent diseases should be individualized,depending on the location of disease and the type of previous therapy. The treatment options including total pelvic exenteration,pelvic radiation and platinum based chemotherapy.