Patients treated for locally advanced cancer of the uterine cervix, FIGO stages IB2 to IVA, may expect a 5-year survival varying from 75% to 16%, respectively. Even though screening programs in Latin America and the Caribbean were established since the 1960´s, advanced stages continue to impact mortality in these countries. Morbidity and quality-of-life are compromised because most of the patients present with symptoms in these later stages. It is crucial to accurately determine tumour size and extension to surrounding organs, not only to establish prognosis, but also for therapy planning. Positron emission tomography combined with computed tomography is the preferred imaging modality but magnetic resonance imaging has high accuracy characterising the primary lesion. Concurrent cisplatin-based chemoradiotherapy is the standard nonsurgical approach, with a relative risk of death of 0.81 compared to the same radiation therapy alone, showing an absolute survival benefit at five years of 6%. Before or after chemoradiation, additional systemic therapy could be used to improve outcomes in patients with locally advanced cancer of the uterine cervix.
(BELG J MED ONCOL 2018:12(3):118–124)