Early cervical cancer and fertility-sparing surgery: lines of therapy

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6 standard-of-care settings across 4 lines and 2 biomarker subgroups. Rows come from the cancer page's standard of care; the grid places each on its line and subgroup.

Line	All comers	Risk group
Screening, prevention and diagnosis	1	·
Early / localised	1	1
Special situations	1	·
Other settings	2	·

Screening, prevention and diagnosis

Subgroup	Setting	Approach	Products and trials	Guideline	Evidence
All comers	Prevention and detection	HPV vaccination and HPV-based screening with colposcopy for positives.	HPV & HBV vaccinationHPV DNA testing and self-samplingColposcopy and excisional treatment (LEEP/LLETZ, cone)HPV status (HPV-positive / HPV-negative)		86

Early / localised

Subgroup	Setting	Approach	Products and trials	Guideline	Evidence
All comers	Adjuvant after surgery	Pelvic radiotherapy for intermediate-risk features; cisplatin chemoradiation for positive nodes, margins or parametria.	IMRT / IGRT (modern external beam)CisplatinBrachytherapyChemoradiation (chemoradiotherapy, CRT)		93
Risk group	Stage IA2 to IB1 up to 2 cm, low risk	Simple hysterectomy with node assessment (SHAPE) or open radical hysterectomy; sentinel node biopsy where a trial or protocol supports it.	HysterectomySentinel lymph node biopsySENTICOL IIIMRI		68

Special situations

Subgroup	Setting	Approach	Products and trials	Guideline	Evidence
All comers	Fertility preservation	Cone or simple trachelectomy for IA disease; radical trachelectomy with node assessment for IB1 tumours up to 2 cm.	Colposcopy and excisional treatment (LEEP/LLETZ, cone)Sentinel lymph node biopsyMRI		68

Other settings

Subgroup	Setting	Approach	Products and trials	Guideline	Evidence
All comers	Stage IA1 without lymphovascular invasion	Cone biopsy with clear margins or simple hysterectomy; no node assessment needed.	Colposcopy and excisional treatment (LEEP/LLETZ, cone)Hysterectomy		40
All comers	Stage IB1 to IB2, standard	Open radical hysterectomy with pelvic lymphadenectomy; minimally invasive radical hysterectomy avoided after LACC.	LACC (Laparoscopic Approach to Cervical Cancer)Caution: minimally invasive radical hysterectomy for early cervical cancerRobotic & minimally invasive surgeryMinimally invasive surgery (laparoscopic, robotic, VATS)		48

Sequence and caution pairings

CautionStandard of care

Caution: minimally invasive radical hysterectomy for early cervical cancer

Keyhole radical hysterectomy, though less painful, led to more recurrences and deaths than open surgery in the LACC trial. Open surgery is the standard until protective techniques are proven.

Lines and subgroups are parsed from the setting text of each standard-of-care row and can misclassify an unusual phrasing; the row’s own setting is always shown. Guideline chips reflect the NCCN category and ESMO-MCBS grade recorded on the cancer page, checked on its stated date. Not medical advice.