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Diagnosis,therapy and follow up of patients with invasive carcinoma of the cervix

Mariusz Bidziński, Ryszard Krynicki, Krzysztof Bujko

Affiliacja i adres do korespondencji
GIN ONKOL, 2003, Vol 1 Numer 1
Streszczenie


Diagnosis

Precise diagnosis and staging of carcinoma of the cervix is crucial for optimal treatment of patients with this malignancy.
All the diagnostic steps described below are needed for confirming the diagnosis and establishing a clinical stage of the disease.
A direct biopsy of the cervical tumor with microscopic examination of the specimen plays a principal role in establishing the diagnosis of cervical cancer.
For proper staging of the disease the following diagnostic steps have to be completed:
1. Vaginal and rectal bimanual examination
2. Chest X-ray
3. US or CT of the whole abdomen (liver, kidneys, retroperitoneal space)
4. Basic blood test (TBC, BUN)
5. Cystoscopy for locally advanced cases with anterior vaginal wall involvement or suspected bladder infiltration on US or CT
Biopsy of the suspected lesion is mandatory.
6. Rectoscopy for cases with posterior vaginal wall infiltration
with biopsy of the suspected area
7. For patients with the symtoms of distant metastases additional diagnostic procedures should be performed
- bone scan
- fine needle biopsy of the suspected lesions ( for example paraaortic nodes)
8. For differential diagnosis between adenocarcinoma and poorly differenciated carcinoma of the cervix and endometrium the following procedures should be performed:
- dilatation & curettage with microscopic examination of the specimen
- histeroscopy for selected cases
9. For praeinvasive lesions additional procedures are recommended:
- curettage of the cervical canal
- cytology of the vaginal fornices smear
10. For microinvsive lesion cone biopsy should be performed to establish the stage of the disease

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